Jan 27, 2004
please talk to us about myopathy. is it common in hiv positives? is it more difficult to fix with anabolics? do anabolics have any effect on it? is there any way of stopping myopathy? will i basically waste down to a skeleton over time? i need concrete answers, because all the doctors have been really shy about talking to me about this. thank you for you honesty.
Response from Dr. Henry
Myopathy is a nonspecific term that can apply to any condition effecting muscle tissue. In the context of HIV infection it is not a very common condition in the US these days. Myopathy can be caused by HIV itself or treatment (most often beleived to be due to mitochondrial toxicity from nucleoside drugs such as AZT). When we used to use AZT at high doses as a single drug we saw it more often than we do now with lower doses and combined with other effective drugs. Myopathy is not the same as muscle wasting which can be due to progressive AIDS and nutritional/hormonal problems. Myopathy is treated by effective use of HIV meds (if due to HIV) or switching off an offending drug (if due to a drug toxicity). Anabolic steroids have little role in the management of myopathy but do get used as a part of a multi-prong approach to muscle wasting. I directly manage or assist in managing hundreds of HIV+ persons on treatment--the rate of myopathy in our clinic is quite low (< 5%) and doesn't seem to be inevitable (= I expect most patients will not develop it). KH
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