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mr popular
Oct 22, 2002

Hey Dr. Bob!

I can see you are obviously flooded with emails and questions, so I'll make this short and sweet. Weight loss during early HIV infection: associated with faster disease progression? Furthermore, if one loses a certian amount of tissue during acute infection, is it usually unreasonable to expect to get it all back? How about get it all back and even gain some [muscle]? Let's say the subject is in his early 20s, is that basically it for him as far as gaining muscle tissue is concerned (body, face, hands, ankles, etc)?

OK, it wasn't as short and sweet as I promised, but could you advise?

Thanks Tortilla

Response from Dr. Frascino

Hey Tortilla,

The biggest problem in HIV disease isn't so much weight loss, but rather loss of lean body mass. Maintaining lean body mass (muscles, organs, etc.) is associated with improved survival. HIV wasting causes loss of lean body mass while preserving fat. That's not helpful. Can you regain lean body mass and even build some? Absolutely. How do you do that? Diet is extremely important. You may need to significantly increase your protein intake (like bodybuilders do). Second, you should check to see if your testosterone levels are normal for your age. (If you're in your early 20s, it should be sky-high normal. 20-somethings should be continuously horny, right?) Third, you can check for loss of lean body mass by having a test called BIA (Bioimpedance Assay). If you are losing or have lost lean body mass, you may need an anabolic steroid to help regain it. (Oxandrin is my personal favorite). Fourth, you've got to hit the gym and do resistance weight training. Pumping iron works, HIV+ or not!

Finally, I should mention I'm talking about weight loss and HIV wasting in terms of loss of lean body mass, not lipodystrophy. Lipodystrophy is a whole other topic. That involves redistribution of fat - Lipoatrophy (fat loss) in the face and extremities, and lipohypertrophy (fat deposition) in the abdomen, female breast, and back of the neck (buffalo hump). I just wanted to make sure you weren't lumping weight loss/AIDS wasting with lipodystrophy, as they are quite different in terms of cause and treatment.

OK Tortilla, put down those tortilla chips and salsa and head for the gym! See you at the bench press, OK?

Dr. Bob


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