Raghavan SS, Mannheimer SB, El-Sadr W; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1996 Sep 15-18; 210 (abstract no. I132).
Harlem Hospital, New York, NY.
Anorexia resulting in decreased nutrient intake appears to be a principle cause of wasting in HIV. Appetite stimulants including megesterol acetate (Megace) and cyproheptadine (Periactin) are being used to treat anorexia associated with wasting. While Megace has been reported to induce a dose-dependent weight gain, there are no data on the efficacy of Periactin in treating wasting in HIV. To compare the effect of these agents on weight (Wt) and body composition, a retrospective analysis of all patients on Megace (n=10) or Periactin (n=11) with 4-12 wks of follow-up was conducted. Megace (M) doses ranged from 160-800 mg/d and Periactin (P) doses were 12-16 mg/d. Body composition was measured using a Bio Impedance Analyzer (RJL, 101 Q). Body cell mass (BCM), fat free mass (FFM), body fat (BF), phase angle (PA), total body water (TBW), extracellular water (ECW) and intracellular water (ICW) were computed using software validated in HIV+ patients. At the initiation of appetite stimulant therapy the mean age was 42, with 6 men/4 women on M and 5 men/6 women on P. Patients were at a mean of 14% (M) and 13% (P) below their usual body weight, and with a mean CD4-lymphocyte count of 149 (M) and 249 (P). Average follow-up was 6.7 weeks. Changes (delta) in wt (all patients) and body composition (subset of 7M/6P) expressed as mean delta in pounds per 4 wks are summarized below. (Table: see text) Though patients gained weight on either agent, only Megace led to a mean increase in BCM (p is less than 0.005). Since decrease in BCM has been correlated with mortality, Megace appears to be superior to Periactin in the treatment of wasting associated with HIV. However, periactin remains a possible option for wasted patients who are unable to take Megace.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Body Composition
- Body Weight
- CD4 Lymphocyte Count
- Electric Impedance
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Weight Gain
Other ID:
UI: 102235081
From Meeting Abstracts