History of HIV-Associated Wasting

Early Case Definition

HIV-associated wasting is a primary manifestation of HIV infection. Wasting consists of involuntary loss of usual body weight, reflecting the significant depletion of body cell mass.1, 2 Wasting was declared an AIDS-defining illness by the Centers for Disease Control and Prevention (CDC) in 1987. The CDC defines wasting as the involuntary loss of at least 10% of ideal body weight with associated symptoms of chronic fever, weakness, or diarrhea in the absence of other related illnesses that could contribute to the weight loss. 3

Impact on Morbidity and Mortality

Wasting is associated with significant morbidity and mortality. Death occurs when a person reaches 66% of ideal body weight or 54% of lean body mass (LBM).4 Patients with HIV-associated wasting have a decreased rate of survival independent of other risk factors.5-7 Such patients are also at increased risk for hospitalization and decreased quality of life.8, 9 As little as 5% weight loss is associated with mortality and the development of opportunistic infections, even after controlling for CD4 cell counts and other prognostic parameters.10