Weight loss and debilitating syndrome are two AIDS-related complications that if not properly treated can be life-threatening. Although anti-HIV drug therapies have helped prevent weight loss and the syndrome, both problems still occur. According to a study published at the end of 1997, more than 25% of HIV-positive people receiving anti-HIV therapies with triple medication still suffered from some degree of weight loss and / or debilitation.
Is There a Difference Between Weight Loss and Impairment?
Yes. As its name says, weight loss refers to loss of body weight. The debilitating syndrome refers to loss of mass or body size, most notably muscle mass (sometimes referred to as "lean body mass"). Very often, both occur at the same time. However, this is not always the case. It is possible that someone who is losing weight does not lose muscle mass. It is also possible that someone losing muscle mass may not lose much weight. For example, some HIV-positive people lose a lot of muscle. But they may experience an increase in fat. This can cause the weight to remain even if the loss of muscle continues.
In people who do not have HIV, weight loss is usually not a problem. For example, someone who diets will eventually lose weight. To compensate for a lack of food intake, the body will naturally burn fat - either in the blood or stored in the cells - to help supply its need for energy. At the same time, the body works to protect proteins during periods of diet or physical activity. Protein is needed to build muscles, cells and organs in the body. In other words, most people can afford to lose weight. They can not afford to lose protein.
In people with HIV, especially during periods of illness (for example, MAC ou TB) the body's demand for energy increases. Turning fat into energy also requires a lot of body work. To help save energy, the body can go after protein to fuel its energy needs. This is because protein is much easier to convert to energy than fat. Also, protein is needed to help repair damaged organs and to replace cells of the immune system lost during periods of illness.
If there is not enough protein in the blood - which can occur if someone is not consuming all the proteins they should during the time of illness - the body will go after a greater source of body proteins: the muscles. Depending on the energy needs of the body, which depends on the severity of the disease and how long it lasts, many or few muscles can be lost. And although losing small portions of muscles is not usually serious, losing large portions of muscles can be dangerous.
There are essentially two different types of loss. The first one reflects periods of rapid weight loss and muscle. As discussed above, this type is most commonly found in people suffering from particular opportunistic infections, such as MAC, tuberculosis or Pneumocystis pneumonia (PCP). Given the benefits of anti-HIV therapies and prophylaxis, HIV-positive people now have a much better chance of either avoiding or recovering faster from OIs. This is certainly good news in terms of preventing one of the most common types of debilitation.
The second type reflects more gradual losses of both weight and muscles. Unlike the first type, which almost generally applies to people with AIDS, gradual loss can occur at any time. This can also occur for a number of reasons and may be due to HIV infection itself.
Translation Rodrigo S. Pellegrini
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