HIV – Associated

FOR HEALTHCARE PROVIDERS

THE PATHOGENESIS OF HIV-ASSOCIATED WASTING IS MULTIFACTORIAL1

Contributing factors for HIV-associated wasting 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 HIV-associated wasting. Watch this video to see inside the body and learn more about why HIV-associated wasting may occur.

Metabolic Changes

Multiple factors, such as elevated resting energy expenditure, hormonal imbalance, elevated proinflammatory cytokines, and stress, may promote a shift in metabolism towards 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

Endocrine Dysfunction

HIV-associated wasting 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 HIV-associated wasting.2

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 HIV-associated wasting.2,4,5

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 HIV-associated wasting. Learn more about how these various changes can impact a patient’s ability to maintain lean body mass, weight, and energy.6-8

HIV-associated wasting is still prevalent in the United States today. Find out more by considering the real-world evidence.

Learn about the symptoms your patients may be experiencing so that you can recognize the signs and begin diagnosing HIV-associated wasting.

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

Learn more about a specific treatment option for 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.