Wasting

Christopher J. Hoffmann, M.D., M.P.H.
Wasting is a topic covered in the Johns Hopkins HIV Guide.

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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.

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Last updated: August 12, 2019