TreatmentUpdate79 - Vol. 7, No. 9; July 1997
Sean Hosein

Unintentional weight loss can be a problem for some people with HIV/AIDS. It may be caused by a variety of factors, including a reduced ability to absorb nutrients, infections of the intestines or changes in energy cycles. PHAs tend to lose muscle (lean body mass) because the body breaks down muscle to form the protein it needs. Women with HIV infection lose both fat and muscle. The remaining muscle tissue becomes weaker and this causes problems for PHAs wanting to carry out their regular daily activities. Sometimes weight loss can be stopped once the cause -- such as an infection -- has been discovered. In other cases, the weight loss may be due to changes in the body's energy cycles. In such cases, protein supplements along with drugs such as growth hormones, anabolic steroids and testosterone can help people regain muscle. One anabolic steroid of interest is oxandrolone (Oxandrin«). This product helps build muscle without causing serious liver damage in the short term, that is 4 months. It also stimulates the production of growth hormone.

Study details

Researchers reported information on 50 male HIV-infected subjects who were experiencing unintentional weight loss and muscle weakness. Subjects were divided into three groups:

* placebo (fake oxandrolone)

* oxandrolone - 5 mg/day

* oxandrolone - 15 mg/day

Neither researchers nor subjects knew who received which drug (or fake drug). At the start of the study the average CD4+ cell count among the three groups ranged between 110 and 165 cells. The study lasted 4 months.

Results

Subjects who received oxandrolone 15 mg/day gained an average of nearly 3 kg, which they maintained throughout the study. Those subjects receiving oxandrolone 5 mg/day stopped losing weight, while those on placebo continued to lose weight, to an average of 4 kg by the 4th month. As well, subjects on oxandrolone 15 mg/day "reported increased appetite and physical activity...over time compared to those in the placebo group." These differences between the placebo and the oxandrolone 15 mg/day group were statistically significant; that is, not likely due to luck alone.

The drug did not appear to have any effect on CD4+ cell counts and the only side effect that may have been associated with its use was fever. Oxandrolone did not cause any liver damage, and researchers described it as being "well tolerated." Based on results from this study, oxandrolone might be useful in treating some cases of HIV-related weight loss, at least in the short term.

REFERENCES:

1. Berger JR, Pall L, Hall CD, et al. Oxandrolone in AIDS-wasting myopathy. AIDS 1996;10(14):1657-1662.

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