Wasting

CLINICAL

• Wasting: Unintentional weight loss >10%; may also be defined by unintentional weight loss >5% over 3 months or a BMI < 18.5.
• Wasting syndrome: Unintentional weight loss >10% plus diarrhea or chronic weakness and documented fever for ≥30 days.
• Wasting syndrome is an AIDS-defining condition (category C); wasting is evidence of symptomatic HIV infection (category B).
• Seen during critical illness and hospitalization, may prolong convalescence.
• Likely multifactorial related to a proinflammatory state (with potential associated anorexia), hypogonadism, and malabsorption.
• Must be differentiated from lipoatrophy, which is isolated fat loss (see Lipodystrophy). Wasting/weight loss is consequence of AIDS disease progression and OIs, while lipoatrophy often seen in pts on some less-used ART regimens.