TreatmentUpdate78 - Vol. 7, No. 8; June 1997
Sean Hosein

Most studies of HIV-related weight loss have focussed on males. This research has provided useful ways to manage weight loss and low energy levels in HIV-infected men. Now doctors are finally studying similar problems in HIV-infected women, the results of some of which we report below.

Study details

Doctors in Boston studied 4 groups of women:

* 12 healthy, non-HIV-infected subjects;

* 12 HIV-infected subjects without wasting;

* 10 HIV+ subjects who had lost at least 10% of their weight (described by the doctors as 'early wasting');

* 9 HIV+ subjects with more serious weight loss (called 'late wasting')

None of the women had active infections when they entered the study, nor were they using drugs (anabolic steroids, estrogen, ketoconazole, Megace«, Prednisone«) that might have affected their production of hormones.

Results -- what kind of weight loss?

Researchers found that women with early and late wasting were losing a significant amount of body fat and muscle. Indeed, they lost about 4 times more fat than muscle.

Results -- burning up energy

The women's energy cycles seemed to be abnormal; their bodies used up more energy to keep functioning than was necessary. This contributed to further weight loss since the women were not eating extra food to compensate.

Results -- hormones and periods

On average, about 20% of the women had stopped having their periods, something which was most common in women with late wasting. Women who had stopped having their periods were likely to have lower than normal levels of the female hormone estradiol and the male hormone testosterone. Women with early and last wasting also had lower than normal levels of another hormone called DHEA (dehydroepiandrosterone). Women with low levels of male hormones were more likely to have muscle loss than women who had normal levels of these hormones. The level of growth hormone was similar among all 4 groups of women.

Therapy

The results of this study suggest that women with weight loss due to HIV/AIDS have less than normal levels of male hormones. Decreased male hormone levels probably play a role in the loss of muscle tissue. The researchers are not sure why the HIV+ women in this study had low levels of testosterone. They think that the glands that produce and regulate sex hormones (adrenal and pituitary glands) may have been damaged by HIV. These doctors now want to conduct experiments on HIV-infected women with wasting, giving them small amounts of male hormones. Since growth hormone levels were within the normal range in the study subjects, the researchers don't think that supplementing these levels would prove useful in treating HIV-infected women.

REFERENCES:

1. Grinspoon S, Cocoran C, Miller K, et al. Body composition and endocrine function in women with Acquired Immunodeficiency Syndrome wasting. Journal of Clinical Endocrinology and Metabolism 1997;82(5):1332-1337.

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