Effects of Androgen Administration in Men with the AIDS Wasting Syndrome

Grinspoon, Steven; Corcoran, Colleen; Askari, Hasan; Schoenfeld, David; Wolf, Lisa; Burrows, Belton A.; Walsh, Mark; Hayden, Douglas; Parlman, Kristin; Anderson, Ellen J.; Basgoz, Nesli; Klibanski, Anne

doi:10.7326/0003-4819-129-1-199807010-00005

Cited by 208 publications

(98 citation statements)

References 30 publications

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“…Similarly, testosterone and other anabolic steroids have been shown to increase lean mass in healthy young men and in patients with HIV infection (Grinspoon et al, 1998), but the potential side effects include liver damage, testicular atrophy, and hyperlipidemia. With GH, there is also the concern that the increase in mass is not accompanied by an increase in strength (Yarasheski et al, 1995), so it is not clear whether GH actually increases muscle protein or whether much of the lean gain is in the visceral compartment.…”

Section: Treatment Of Sarcopeniamentioning

confidence: 99%

Sarcopenia and its implications for the elderly

2000

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Sarcopenia is the loss of muscle mass and strength with age. Sarcopenia is a part of normal aging, and occurs even in master athletes, although it is clearly accelerated by physical inactivity. Sarcopenia contributes to disability, reduced ability to cope with the stress of a major illness, and to mortality in the elderly. The etiology of sarcopenia is unclear, but several important factors have been identi®ed. These include loss of alpha motor neurons, decline in muscle cell contractility, and several potential humoral factors, such as androgen and estrogen withdrawal and increase in production of catabolic cytokines. Treatment of sarcopenia with progressive resistance training is safe and effective, but dissemination of this technique to the general population has yet to occur. As the number of elderly persons increases exponentially in the new century, a public health approach to prevention and treatment of sarcopenia, based on increasing physical activity at all ages, will be crucial to avoiding an epidemic of disability in the future.

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Section: Treatment Of Sarcopeniamentioning

confidence: 99%

Sarcopenia and its implications for the elderly

2000

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“…In contrast, V1 does not appear to promote fat gain; however, V-1 Immunitor effect on wasting V Jirathitikal et al this needs to be further tested by more objective tests like bioimpedance test. In a randomized study, testosteronetreated patients gained 2 kg of fat-free mass as opposed to loss of 0.6 kg in patients on placebo (Grinspoon et al, 1998). Similar to V1 experience, patients who received testosterone reported that they felt better, had improved quality of life, and improved appearance.…”

Section: Discussionmentioning

confidence: 90%

“…However, it is expensive as it could cost at least $40 000 per year to use. Testosterone and anabolic steroids have been studied alone and in combination with exercise, and have shown promising results, especially in males (Grinspoon et al, 1998). Thalidomide was reported to reverse weight loss, but its use was limited by adverse reactions at higher doses (Kaplan et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Increased body weight and improved quality of life in AIDS patients following V-1 Immunitor administration

Jirathitikal¹,

Metadilogkul

Bourinbaiar³

2003

Eur J Clin Nutr

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Objectives: Development of affordable and safe therapy to reverse the loss of body mass is of critical importance since AIDSrelated wasting is associated with increased mortality. Method: We have demonstrated earlier that oral therapeutic HIV vaccine, V-1 Immunitor (V1), tested in a small group of AIDS patients in Thailand not only increases T-cell counts and decreases the viral load but also results in weight gain and prolonged survival. To further expand this observation, we retrospectively analyzed 650 HIV-positive patients who were followed for an average of 23 weeks.Results: The treatment with V1 resulted in a sustained and statistically significant increase in body mass across the whole population (mean7s.e.; 1.570.4 kg; P ¼ 6.5EÀ015). Among them, 384 (59%) patients gained an average of 4.270.2 kg; 107 (17%) had unchanged weight; and 159 (24%) had lost 3.870.3 kg. Thus, the prevailing majority of patients (76%) were able to gain or maintain weight. Treatment was well tolerated; in a survey of health status in a comparable but separate group of 382 patients, about 85% reported subjective improvement after V1 treatment, 6% reported no difference, and 9% of the patients reported minor adverse reactions, which did not last more than 1 week. Subjective improvement coincides with the reduction or clearance of oral thrush or mucocutaneous candidiasis in 87.5% of the patients. Conclusions:In an open label setting, V1 increases body weight, subjective assessment of quality of life, and is safe and effective for HIV patients with weight loss. These data provide the impetus of using V-1 Immunitor as an affordable and easy-toadminister means of treating AIDS-associated wasting and opportunistic infections.

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“…**Po0.01 for the change from baseline between the testosterone group and placebo group by analysis of covariance. From Grinspoon et al, 14 reprinted with permission from Annals of Internal Medicine.…”

Section: Effects On Body Composition and Muscle Massmentioning

confidence: 99%

“…Several studies indicate that testosterone treatment helps prevent loss of lean body and muscle mass in HIV-infected patients. [14][15][16][17][18][19] In a study of 51 HIV-positive men with wasting and low testosterone levels, patients were randomized to placebo or testosterone enanthate at 300 mg intramuscularly (i.m.) every 3 weeks for 6 months.…”

Section: Effects On Body Composition and Muscle Massmentioning

confidence: 99%