Abstract
Patients with AIDS often develop malignancies and secondary infections that cause weight loss. To examine the etiology of this weight loss, the investigators examined patients with HIV, AIDS, and AIDS plus secondary infection (AIDS-SI) for resting energy expenditure (REE), caloric intake, and short-term weight change over a 28-day period. Although caloric intake during that period for HIV positive and AIDS patients was similar to that of control subjects, it was 36% lower for AIDS-SI patients. The HIV positive and AIDS subjects showed no short-term change in weight, whereas the AIDS-SI subjects demonstrated a 5% weight loss. The HIV positive, AIDS, and AIDS-SI groups exhibited an increase over controls in REE of 11%, 25%, and 29%, respectively. Thus, the AIDS-SI patients consumed 17% fewer calories than would be needed to support the elevated REE, which accounted for the weight loss over the 28 days. Consequently, a hypermetabolic effect caused by the existence of a secondary infection coupled with the HIV infection results in an increase of REE that is not counterbalanced with daily dietary intake. This causes significant weight loss over a short period of time.
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