Pathogenesis

HIV-positive patients experiencing unintentional weight loss may be in a catabolic state¹

Lean body mass is broken down for use as energy¹
Dysfunction within multiple body systems contributes to this catabolic state and HIV-associated wasting (HIVAW)¹

Contributing factors for HIVAW have been identified across a number of physiological systems

Pathogenesis of Wasting

Metabolic changes, endocrine abnormalities, immune dysregulation, and gastrointestinal issues may all play a role in HIVAW. Watch this video and learn more about what is happening inside the body and why HIVAW may occur.

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Metabolic Changes

Multiple factors, such as elevated resting energy expenditure, hormonal imbalance, elevated proinflammatory cytokines, and stress, may promote a shift in metabolism toward excessive catabolic activity. In this catabolic state, the body is shifted to breaking down proteins and other molecules instead of being in equilibrium. This dysregulation can lead to weight loss and an inappropriate depletion of lean body mass.^1-3

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Endocrine Dysfunction

HIVAW has been attributed in part to endocrine dysfunction. Disruptions of the hormonal regulatory axes together with abnormal hormone levels lead to problems regulating the metabolism of proteins, lipids, and carbohydrates which can lead to loss of lean body mass, weight loss, and loss of energy. Explore how these issues, in addition to other endocrine system dysfunctions, may cause symptoms of HIVAW.²

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Immune Dysregulation

Both the innate and adaptive immune systems can become dysfunctional in response to HIV infection. Even when the virus is controlled, latently infected cells remain. Dysregulation of cytokine production is a key immunological abnormality associated with HIVAW.^2,4,5

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Gastrointestinal Changes

Even in HIV-positive patients with undetectable viral loads, the gut-associated lymphoid tissue, or GALT, remains a latent reservoir for the virus. This leads to changes in the structure and function of the gut that may contribute to HIVAW. Learn more about how these various changes can impact a patient’s ability to maintain lean body mass, weight, and energy.^6-8

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HIVAW is still prevalent in the US, even in the modern ART era. See the latest real-world evidence.

Learn about the symptoms your patients may be experiencing so that you can recognize the signs and begin diagnosing HIVAW.

The people depicted on this website are not actual healthcare providers or patients with HIV-associated wasting.

References: 1. Gelato M, McNurlan M, Freedland E. Role of recombinant human growth hormone in HIV-associated wasting and cachexia: pathophysiology and rationale for treatment. Clin Ther. 2007;29(11):2269-2288. 2. Dudgeon WD, Phillips KD, Carson JA, Brewer RB, Durstine JL, Hand GA. Counteracting muscle wasting in HIV-infected individuals. HIV Med. 2006;7(5):299-310. 3. Cohen S, Nathan JA, Goldberg AL. Muscle wasting in disease: molecular mechanisms and promising therapies. Natur Rev. 2015;14:58-74. 4. Chereshnev VA, Bocharov G, Bazhan S, et al. Pathogenesis and treatment of HIV infection: the cellular, the immune system and the neuroendocrine systems perspective. Int Rev Immunol. 2013;32(3):282-306. 5. Atfeld M, Gale M. Innate immunity against HIV-1 infection. Nature Immunol. 2015;16(6):554-562. 6. Koethe JR, Heimburger DC, PrayGod G, Filteau S. From wasting to obesity: the contribution of nutritional status to immune activation in HIV infection. J Infec Dis. 2016;214(suppl 2):S75-S82. 7. Dandekar S. Pathogenesis of HIV in the gastrointestinal tract. Curr HIV Aids Rep. 2007;4(1):10-15. 8. Márquez M, Fernández Gutiérrez del Álamo C, Girón-González JA. Gut epithelial barrier dysfunction in human immunodeficiency cirus-hepatitis C virus coinfected patients: influence on innate and acquired immunity. World J Gastroenterol. 2016;22(4):1433-1448.

THE PATHOGENESIS OF HIVAW
IS COMPLEX AND MULTIFACTORIAL¹

HIV-positive patients experiencing unintentional weight loss may be in a catabolic state¹

Contributing factors for HIVAW have been identified across a number of physiological systems

Pathogenesis of Wasting

Metabolic Changes

Endocrine Dysfunction

Immune Dysregulation

Gastrointestinal Changes

Learn more about a specific treatment option for HIV-associated wasting

You are now leaving HIVWasting.com.

The following site is intended for US healthcare professionals only.

THE PATHOGENESIS OF HIVAW IS COMPLEX AND MULTIFACTORIAL1

HIV-positive patients experiencing unintentional weight loss may be in a catabolic state1

Contributing factors for HIVAW have been identified across a number of physiological systems

Pathogenesis of Wasting

Metabolic Changes

Endocrine Dysfunction

Immune Dysregulation

Gastrointestinal Changes

Learn more about a specific treatment option for HIV-associated wasting

You are now leaving HIVWasting.com.

The following site is intended for US healthcare professionals only.

THE PATHOGENESIS OF HIVAW
IS COMPLEX AND MULTIFACTORIAL¹

HIV-positive patients experiencing unintentional weight loss may be in a catabolic state¹