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Combination Megestrol Acetate, Oxandrolone, and Dietary Advice Restores Weight in Human Immunodeficiency Virus
Author(s) -
Mwamburi D. Mkaya,
Gerrior Jül,
Wilson Ira B.,
Chang Hong,
Scully Ed,
Saboori Shiva,
Miller Laurel,
Forfia Janet,
Albrecht Mary,
Wanke Christine A.
Publication year - 2004
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426504019004395
Subject(s) - medicine , oxandrolone , body mass index , megestrol acetate , weight loss , lean body mass , quality of life (healthcare) , cohort , body weight , obesity , cancer , hormone , growth hormone , nursing
Background: We examined changes in total body weight (TBW) and health‐related quality of life (HRQL) during prolonged combination weight‐gaining therapy and dietary advice in HIV. Design: This was a cohort study of patients initially randomized to single agent therapy for 2 months, megestrol acetate (800 mg daily), or oxandrolone (10 mg twice daily), followed by both agents and dietary advice for 5 months. Methods: Two community health clinics and 1 urban infectious disease clinic were included, as were HIV‐positive adult patients receiving highly active antiretroviral therapy with documented 5% weight loss. TBW and HRQL were measured after 7 months (7 m). Results: Twenty‐nine of 39 participants completed 7 m. The average sample age was 40 years, 75% were male, and 52% were of color at enrollment. Baseline mean TBW and body mass index (BMI) were 62.5 kg and 21 kg/m 2 , respectively. Net gains in TBW, lean body mass, and fat during the 7 m were 5.3 kg (8.5% of baseline), 2.1 kg, and 3.1 kg, respectively ( p < .01 for each). BMI increased to 23.1 kg/m 2 ( p < .01). Dietary intake increased by 467 kcal/day ( p = .03). Physical health improved by 5.7 (100‐point scale, p < .01), and mental health was unchanged (–4.2, p = .11). In multivariable models, female gender ( p < .01), lower baseline HIV viral load ( p = .03), and increasing age ( p < .01) were associated with TBW gain. Injection drug use ( p < .01) and higher baseline HIV viral load ( p < .01) were associated with reduction in physical health. Conclusions : Prolonged combination therapy with megestrol acetate, oxandrolone, and dietary advice could reverse weight loss and low BMI associated with incomplete viral suppression and improve physical health.