• Wasting is associated with significant morbidity and mortality. Patients experience a variety of effects from the condition.

• These include increased weakness and decreased physical function, both of which have a negative impact on a patient’s quality of life.1

• HIV-associated wasting also results in impaired immune function and an increase in disease complications.2,3 As little as 5% weight loss is associated with the development of opportunistic infections, independent of CD4 cell counts and other prognostic markers. Such morbidity can lead to an increase in hospitalizations for these patients.

• Probably most important, however, is the impact HIV-associated wasting has on survival. Early work by Kotler and colleagues demonstrated a decreased rate of survival in patients with wasting independent of other risk factors.4 Death can occur when a person reaches 66% of ideal body weight.

• Given the strong association between wasting and survival, clinicians need to be vigilant for signs and symptoms of the condition so that effective treatment can be implemented.

References:

1. Turner J, Muurahainen N, Terrell C et al. Nutritional status and quality of life. Program and abstracts of the X International Conference on AIDS; August 7-12, 1994. Abstract 431B.

2. Cohan GR, Murrahainen N, Guenter P et al. HIV-related hospitalizations, CD4 percent and nutritional markers. Program and abstracts of the International Conference on AIDS; July 19-24, 1992. Abstract Pu.B.7113.

3. Wheeler DA, Murrahainen N, Elion R et al. Change in body weight (WT) as a predictor of death and opportunistic complications (OC) in HIV by history of prior OC. Program and abstracts of the XI International Conference on AIDS, Vancouver, British Columbia; July 7-12, 1996. Abstract Tu.B.2383.

4. Kotler DP, Tierney AR, Wang J, Pierson RN Jr. Magnitude of body-cell mass depletion and the timing of death from wasting in AIDS. Am J Clin Nutr. 1989;50:444-7.