AIDS Wasting Syndrome

Medically Reviewed by Jonathan E. Kaplan, MD on December 12, 2022
4 min read

AIDS wasting syndrome isn't a specific disease. Someone with AIDS is said to have it when they've lost at least 10% of their body weight, especially muscle. They may have also had diarrhea for at least a month, or extreme weakness that's not related to an infection.

We don't understand it well, but it doesn't happen as much as it used to, thanks to antiretroviral therapy (ART), the drugs that treat HIV. Still, it's a significant threat in AIDS patients. It makes opportunistic infections, dementia, and death more likely. Even a weight loss of 5% can raise your chances of trouble.

Keep an eye on your weight and eat well, even when you're not hungry. Call your doctor if you lose weight suddenly, have severe diarrhea, or get an infection that affects your tummy and guts.

The top of the list is not taking ART medications, so don't miss a dose.

You may simply not be eating enough to get the nutrients your body needs to do its best.

When you have HIV, especially if you are not taking ART medications, you burn calories fast. This could be because your immune system is working hard, or it may be because HIV has affected the hormones that control your metabolism. Whatever the reason, you'll need more calories to keep up your weight. This can be a challenge because HIV can take away your appetite.

Other things that may make you not want to eat and lead to weight loss:

  • Medication side effects like nausea, changes in taste, or mouth tingling
  • Symptoms of opportunistic infections, like a painful throat or feeling full
  • Lack of money or energy
  • Depression

Sometimes, your body may not be absorbing the nutrients that you are getting. HIV can damage the lining of your intestines, or you may have an infection that could be interfering. Diarrhea is a side effect of some medicines.

People with HIV tend to have high levels of cytokines. These trigger your body to make more fats and sugars, but fewer proteins, the building blocks for your muscles.

Your doctor will ask you questions about weight loss and other symptoms, your diet, the medications you're taking, and your recent moods.

If your doctor wants to check the tissues in your body, you'll need a body composition test. Bioelectrical impedance analysis (BIA) is one example of this kind of test: While you're lying down, someone will measure how well a painless electrical signal travels through your body. You should have this testing done somewhere that has experience with AIDS wasting syndrome.

You may also need tests to help your doctor find out if you have problems absorbing nutrients.

Megestrol acetate (Megace) is an appetite stimulant. Some doctors don't recommend it though, because it can build body fat and slow the release of hormones from sex glands.

Marijuana is legal for medical uses in some states. It can make you hungry, soothe nausea, and lessen pain. But it can cause breathing problems such as bronchitis.

Dronabinol (Marinol), a man-made form of an active ingredient in marijuana, has similar effects as marijuana and may improve your mood and stabilize your weight. However, insurance companies often don't pay for it.

Your doctor may adjust your ART drugs to avoid or ease diarrhea. And you should treat any opportunistic infections that affect your intestines.

Diet changes can also prevent and relieve diarrhea. Limit fat, lactose (in dairy products), and insoluble fiber found mainly in whole grains and some vegetables. Eat more soluble fiber from oat bran, nuts, lentils and beans, and some fruits and veggies. Stay away from caffeine, alcohol, and high-sugar sweets.

Nutritional supplements (like Advera and Ensure) may help if you're not getting enough nutrients.

Somatropin (Serostim and other brand names), a human growth hormone, helps you gain weight and lean body mass. It's approved by Medicaid, but it's also expensive. And it causes high blood sugar levels and muscle and joint pain.

Progressive resistance training can help you develop lean body mass. When you exercise, you can gradually increase weight, repetitions, or sets to make you stronger.

Testosterone and anabolic steroids may help you build muscle, but because they're related to sex hormones, they can cause male infertility or irregular periods. They can also lower your good cholesterol (HDL).

Thalidomide (Thalomid) can lower levels of cytokines. The down side is possible muscle weakness. You may also get tingling or burning in your arms or legs.