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Immune Function & Anabolic Steriods
Dec 9, 2006

Right or wrong, I was a body builder and until recently was taking stanazolol and dianabol on one of my cycles and decca (nandrolone) on another. I have recently been diagnosed +ve and had a bout of PCP. Now that I am recovered from the PCP I want to get back into the gym and resume my normal program but I am a little unsure about the danger of the steriods.

I have heard that some steroids can have negative consequences for the immune system and TCell count. I am on Ziagen, Sustiva and Epivir as well as Bactrim to ward off the evil PCP and Sporanox for fungal suppression.

I was wondering about your opinion in respect to the steroids mentioned above and how they could potentially effect my immune system and/or interact with the HIV and other meds mentioned.

I have also read Nelson Vergel's "Built to Survive" book which from my recollection doesn't mention any link between steriods and immune problems.

This book in fact suggests the opposite and lauds the benefits of steriods to HIVers for building lean mass to protect against wasting.

I don't live in the US and therefore I am not interested in hearing how legal or illegal steroid use is in the US.

Just looking for an opinion.

Response from Dr. Pierone

Hello, and thanks for posting.

I am not aware of adverse effects of androgenic or anabolic steroids on immune function in patients with HIV infection. As you indicate, some people feel that steroids should be used more often in HIV management in order to build muscle mass. No one doubts the ability of these agents to promote increased muscle mass and improved athletic performance.

But like any pharmacologic intervention, adverse events must be considered, and are commonly seen when these medications are used in patients with HIV infection. There is often a negative impact on lipid levels, particularly lowering of the good HDL cholesterol, Some of these agents lead to an increase in red blood cells, leading to thicker blood. Since some of the HIV medications (protease inhibitors in particular) also have negative effects on blood lipids the combination of HAART and steroids may result in a thicker, fat-laden blood (yikes, not a pleasant image), so common sense would urge caution.

That said, selective use of anabolic steroids in patients with muscle wasting and functional decline may be extremely useful.

Also, to clarify the legal situation for our readers, anabolic steroids may be used legally in the U.S. as a prescription medication, no different from many other medications. The illegal aspect of use is when steroid use occurs outside of a properly documented medical treatment plan.



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