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Weight loss - Wasting

Weight loss that eventually leads to clinical condition is often indicative of infection and serious illness. However, weight loss alone is not a sufficient measure of nutritional status and muscle wasting.

The metabolically active cellular components of the body know as Body cell Mass which reflects the functional status of the patients has been found to be a better indicator then body weight of survival from wasting diseases.

Regular assessment of individuals Body Composition with Maltron analysers provides clinicians with immediate insight to loss of BCM or changes in body components.

Apart from identifying wasting diseases and psychological eating disorders, body composition is important for monitoring the efficacy of clinical intervention.

 

Muscle Wasting diseases and disorders

HIV and AIDS

Human immunodeficiency virus (HIV), a class of retroviruses causing AIDS, HIV is transmitted through various channels, contaminated blood transfusions, nonsterile needles or sexual intercourse. HIV has affinity for T-lymphocytes were the virus multiplies and in some cases, destroys function.

Some characteristics changes on Body Composition in HIV/AIDS patients

 

Monitoring Body Composition

HIV is associated with wasting it was reported around 51% of Fat free mass accounts of body weight in men and 18% of body weight in women. It has been reported the hydration of Fat free Mass in AIDS patients did not alter from healthy values (~73%). Additionally loss was found to be less than the FFM loss. Therefore AIDS patients are likely to have an increase Total Body Mass/Fat Free Mass (TBM/FFM) ratio and an increased Fat Free Body density (FFBd).

Wasting prognoses is of morbidity and mortality in HIV patients. Simply monitoring body weight or BMI of this group is not sufficient. In HIV patients it was found that quantifying of BCM is the most important single measurement in the treatment.

Due to the easy of implementation in clinical setting Maltron BioScan has been found to indispensable tool to estimate BCM. Reactance (Xc) has been found to be a good predicator of BCM, where impedance (Z) was better indicator of Fat Free Mass and Total Body Water. However, Phase angle has been found to be the single best indicator of survival and has better predictive value than measured with commonly used methods for survival in AIDS patients.

The routine use of Maltron Analysers as screening tool could help identify these diseases at earlier stage helping implement effect treatment.



TECHNICAL PAPERS

Flynn N, Enders S, Oster M, Cone L, Hooten T. Megestrol acetate 800 mg/day vs. placebo for treatment of weight loss and anorexia in AIDS patients [abstract]. Int Conf AIDS 1992 Jul 19-24:8(2):B2O5 (abstract no. P0B 3687).

Gold J, Oliver C. Evaluation of megestrol acetate treatment in AIDS [abstract]. Int Conf AIDS 1989 Jun 4-9;5:336 (abstract no. T.B.P. 298).

Oliver C, Rose A, Dwyer R. Allen B, Gold J. Body protein in asymptomatic HIV + ve males: longitudinal study [abstract]. Int Conf AIDS 1992 Jul 19-24; 8(2):B2O6 (abstract no. PoB 3693).

Oster MH, Enders SR. Samuels SJ, Cone LA, Hooton TM, Browder HP, Flynn NM. Megestrol acetate in patients with AIDS and cachexia. Ann Intern Med 1994 Sep 15;121(6):400-8. Comment in: Ann Intern Med 1994 Sep 15;121(6):462-3.

Ott M, Wegner A, Caspary WF, Lembcke B. Intestinal absorption and malnutrition in patients with the acquired immunodeficiency syndrome (AIDS). Z Gastroenterol 1993 Nov;31(11):661-5.

Ropka ME, Sebring N, Anderson R, Hayes C. Effect of nonfasting on accuracy of body composition estimates by bioelectrical impedance analysis (BIA) in HIV infection [abstract]. Int Conf AIDS 1993 Jun 6-11;9(1):528 (abstract no. PO-B36-2359).

Scevola D, Barbarini G, Bottari G, Zambelli A, Franchini A, Oberto L, Marinelli M. Prevalence, etiology and management of AIDS malnutrition [abstract]. Int Conf AIDS 1991 Jun 16-21;7(2):224 (abstract no. W.B.2169).

Scevola D, Barbarini G, Zambelli A, Bottari G. Nutritional status in AIDS patients [abstract]. Int Conf AIDS 1989 Jun 4-9:5:465 (abstract no. Th.B.P.299).

Schwenk A, Burger B, Wessel D, Stutzer H, Ziegenhagen D, Diehl V, Schrappe M . Clinical Risk Factors for Malnutrition in HIV-1-Infected Patients . AIDS . 1993; 7 , N 9: 1213-1219

Schwenk J. Buerger B, Salzberger B, Factkenheuer G, Skorupka M, Ollenschlaeger G, Schrappe M. Clinical risk situations for malnutrition and outcome of nutritional intervention in advanced HIV-disease [abstract]. Int Conf AIDS 1991 Jun 16-21;7(1):228 (abstract no. M. B. 2187)