(June 6, 2002) BETHESDA, Md. -- AIDS and HIV infection have long been known to cause weight loss, a condition called AIDS wasting. With the advent of new medications, catastrophic wasting is no longer very common. However, what is not widely appreciated is that patients with HIV often continue to lose muscle even though their weight is stable. This condition, called cachexia, is slower and harder to detect than wasting, but can eventually take a toll on the person's ability to function and to deal with the stresses of infections or injuries. No easy resolution to cachexia has been available because physicians have not understood the mechanism of cachexia in HIV disease. Until now.

The Study
A Boston medical research team has identified an important first step by determining that cachexia, wasting and weight loss associated with a chronic disease, is a prevalent clinical problem in HIV infected men, even when antiretroviral treatment is administered. They found that cachexia is an immunologically driven process rather than the consequence of inadequate food intake.

Cachexia causes lean body mass loss, without loss of weight, at a more accelerated rate than found in wasting. Previous studies have revealed that in rheumatoid arthritis, excess production of catabolic cytokines interleukin and tumor necrosis factor-a by peripheral blood mononuclear cells (PBMC), spurs cachexia and increased resting energy expenditure (REE) and protein catabolism, without weight loss. Since rheumatoid arthritis is a system disease like HIV infection, the research team sought to link HIV infection to this process that causes cachexia.

The authors of the study, Role of Cytokines and Testosterone in Regulating Lean Body Mass and Resting Energy Expenditure in HIV-Infected Men, are Ronenn Roubenoff, MD, MHS, Paul R. Skolnik, MD, Eric Tchetgen, BA, Donna Spiegelman, ScD, Tamsin Knox, MD and Sherwood Gorbach, MD, all of the Department of Community Health
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Contact: Donna Krupa
djkrupa1@aol.com
703-527-7357
American Physiological Society
11-Jun-2002

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