Human growth hormone to the treatment of the wasting syndrome of HIV/AIDS

Human growth hormone (HGH) is a naturally occurring polypeptide hormone secreted by the pituitary gland and is essential for body growth. Daily secretion of HGH increases throughout childhood, peaking during adolescence, and steadily declining thereafter. In 1985, synthetic HGH was developed and approved by the FDA for specific uses. However, it is commonly abused by athletes, bodybuilders, and aging adults for its ability increase muscle mass and decrease body fat, as well as its purported potential to improve athletic performance and reverse the effects of aging.

Several FDA-approved injectable HGH preparations are available by prescription from a supervising physician for clearly and narrowly defined indications. In children, HGH is approved for the treatment of poor growth due to Turner’s syndrome, Prader-Willi syndrome and chronic renal insufficiency, HGH insufficiency/deficiency, for children born small for gestational age, and for idiopathic short stature. Accepted medical uses in adults include but are not limited to the treatment of the wasting syndrome of HIV/AIDS and HGH deficiency. Dependent on the clinical presentation, pediatric dosages range from 24-100 microgram/kilogram/day and adult dosages from 0.9-25 microgram/kilogram/day, dependent on product. The FDA-approved injectable formulations are available as liquid preparations, or as powder with a diluent for reconstitution.

Using recombinant DNA technology, two forms of synthetic HGH were developed, Somatropin and Somatrem. Somatropin is identical to the endogenous pituitary-derived HGH, whereas Somatrem has an extra amino acid on the N-terminus. Both synthetic forms have similar biological actions and potencies as the endogenous HGH polypeptide. Synthetic HGH also is chemically indistinguishable from the naturally occurring hormone in blood and urine tests.

HGH binds to growth hormone receptors present on cells throughout the body. HGH functions to regulate body composition, fluid homeostasis, glucose and lipid metabolism, skeletal muscle and bone growth, and possibly cardiac functioning. Sleep, exercise, and stress all increase the secretion of HGH.

The use of HGH is associated with several adverse effects including edema, carpal tunnel syndrome, joint pain, muscle pain, and abnormal skin sensations (e.g., numbness and tingling). It may also increase the growth of preexisting malignant cells, and increase the possibility of developing diabetes.

HGH is administered by subcutaneous or intramuscular injection. The circulating half-life of HGH is relatively short half-life (20-30 minutes), while its biological half-life is much longer (9-17 hours) due to its indirect effects.

Human growth hormone is illicitly used as an anti-aging agent, to improve athletic performance, and for bodybuilding purposes. It is marketed, distributed, and illegally prescribed off-label to aging adults to replenish declining hGH levels and reverse age-related bodily deterioration. It is also abused for its ability to alter body composition by reducing body fat and increasing skeletal muscle mass. It is often used in combination with other performance enhancing drugs, such as anabolic steroids. Athletes also use it to improve their athletic performance, although the ability of HGH to increase athletic performance is debatable.

Athletes, bodybuilders, and aging adults are the primary abusers of HGH. Because the illicit use of synthetic HGH is difficult to detect, its use in sports is believed to be widespread. Over the past few years, numerous professional athletes have admitted to using HGH. Bodybuilders, as well as celebrities also purportedly use it for its ability to alter body composition. Aging adults looking to reverse the effects of aging are increasingly using synthetic HGH.

Hepatitis C and diagnosis with HIV

Hepatitis C is usually transmitted through blood-to-blood contact. Needles, syringes and other equipment used to inject drugs, and equipment used to sniff drugs such as straws or banknotes, should never be shared. The sexual transmission of hepatitis C is now an issue of concern. It used to be thought that this was very rare. However, there have been recent reports of increasing numbers of gay men testing positive for hepatitis C. Many of these men are HIV positive and their only risk activity appears to be unprotected anal sex. Sexual activity that carries a risk of contact with blood, such as rougher anal sex, use of sex toys and fisting, seems to have a particular risk of hepatitis C transmission. Group sex, especially in the context of drug use, is also an important risk factor. Using condoms correctly, every time you have sex, not sharing sex toys or washing them between use, and not sharing pots of lubricant can reduce the risk. Mother-to-baby transmission of hepatitis C is thought to be uncommon, but the risk is increased if the mother is also HIV positive. A high hepatitis C viral load increases the risk that a mother will pass on hepatitis C to her baby and, as with HIV, a caesarean delivery reduces the risk. It’s best not to share razors, hair and nail clippers, nail scissors or toothbrushes if you have hepatitis C.

Very few people experience symptoms when they are first infected with hepatitis C. When they do occur, symptoms include jaundice, diarrhoea and feeling sick. In the longer term, about 50% of people with hepatitis C will experience some symptoms. The most common ones are feeling generally unwell, extreme tiredness, weight loss, depression and intolerance of fatty food and alcohol. Although a small proportion of people infected with hepatitis C clear the infection naturally, about 85% will go on to develop chronic hepatitis C. About a third of people will develop severe liver disease within 15 to 25 years. The severity of disease can be affected by the strain of hepatitis C you are infected with. Men, people who drink alcohol, people who are infected with hepatitis C when they are already into middle age, and people with HIV seem to experience faster hepatitis C disease progression. Hepatitis C can cause liver fibrosis (hardening) and cirrhosis (scarring). This damages the liver to such an extent that it cannot work properly, causing jaundice, internal bleeding and swelling of the abdomen. Chronic infection with hepatitis C can cause liver cancer (hepatocellular carcinoma, or HCC). HCC is especially likely to happen in people with cirrhosis, particularly if they drink heavily. There’s also some evidence that smoking can speed up the rate of cirrhosis and increase the risk of liver cancer. Surgery is the most effective form of treatment for liver cancer, but  other options include chemotherapy and treatment with drugs.

You should be tested soon after your diagnosis with HIV to see if you are also infected with hepatitis C. Unlike hepatitis B, there is no vaccine against hepatitis C. If you are in a group at high risk of infection with hepatitis C, it’s recommended that you have regular tests to see if you have been infected. A test is available to measure hepatitis C viral load. Unlike the HIV viral load test, this is not an indicator of when to start treatment. However, it is used to show how effective treatment any hepatitis C is being and how long it should continue. Liver function tests can give an indication of the extent to which hepatitis C has damaged your liver. Liver ultrasounds and biopsies may also be used. People co-infected with HIV and hepatitis C are more likely to develop liver damage than people who are only infected with hepatitis C. However, hepatitis C does not increase your risk of becoming ill due to HIV or responding less well to HIV treatment.

HIV treatment can be used safely and effectively if you are co-infected with HIV and hepatitis C. HIV treatment that suppresses viral load and increases your CD4 cell count can slow the rate of HCV-related liver damage. However, you may be at greater risk of experiencing the liver side-effects which some anti-HIV drugs can cause, and you and your doctor should have this in mind when selecting which anti-HIV drugs to take. It also seems to be the case that people co-infected with HIV and hepatitis C are at greater risk of developing some of the metabolic disorders which anti-HIV drugs can cause (particularly insulin resistance and diabetes). Drugs are available for the treatment of hepatitis C and you should receive your treatment and care from doctors who are expert in the treatment of both HIV and hepatitis C. This may mean that, as well as seeing an HIV doctor, you also need to see a specialist liver doctor.

If you have both HIV and hepatitis C, you should be assessed to see if you would benefit from starting hepatitis C treatment.

If you and your doctor decide that you will start hepatitis C treatment now, and your CD4 cell count is between 350 and 500, you should start hepatitis C treatment first, then start HIV treatment. If your CD4 cell count is between 350 and 500 and you don’t yet need treatment for hepatitis C, you should start HIV treatment.

If your CD4 cell count is under 350, you should start HIV treatment before starting hepatitis C treatment. A number of anti-HIV drugs have interactions with drugs used to treat hepatitis C. The choice of anti-HIV drugs you take will need to be made with these possible interactions in mind.

Before you start treatment for hepatitis C, it is important to know which strain, or genotype, of hepatitis C you have been infected with, as this can predict your response to treatment and the amount of time you will need to take treatment for. There are several hepatitis C genotypes. Type 1 is most common in the UK, and unfortunately responds least well to the currently available treatments for hepatitis C. Genotype 4 is also harder to treat. People with genotypes 2 or 3 respond better to treatment. However, there are new HCV drugs available, and more in development, which should improve the chances of a cure for people with harder-to-treat genotypes.

Factors such as your age, gender, how long you have had hepatitis C, the degree of liver damage and whether cirrhosis has developed are also important in predicting if treatment is likely to be effective. Unlike HIV treatment, treatment for hepatitis C is not lifelong. It consists of 24 or 48 weeks of treatment, and the length of treatment you receive will depend on the hepatitis C genotype you are infected with. A test after twelve weeks of treatment can predict if you are going to respond to treatment.

Drugs are available for the treatment of hepatitis C. The backbone of treatment consists is pegylated interferon and ribavirin. These are taken in combination with an anti-HCV protease inhibitor. This sort of triple combination has been found to be much more effective than dual therapy with pegylated interferon and ribavirin alone. The aim of hepatitis C treatment is to eradicate infection with hepatitis C completely.

Other aims of treatment include normalizing liver function, reducing liver inflammation and reducing further damage to the liver. If you are ill because of HIV, then the aim of hepatitis C treatment is likely to focus on improving your tolerance of anti-HIV drugs, reducing the risk of death from liver problems and improving your overall quality of life. Hepatitis C treatment can have unpleasant side-effects, including a high temperature, joint pain, weight loss, nausea and vomiting and depression. Other side-effects include disturbances in blood chemistry.

Steroid Injecting Bodybuilders At High Risk Of HIV Infection

The medical observer Australia has reported an alarming increase of HIV infection with 1 in 10 steroid users having evidence of infection with either HIV, Hepatitis B and C. In Australia, education for recreational drug users on safe use of needles has lead to a dramatic decrease in HIV and Hepatitis infections. Many anabolic steroid and injectable tanning product users do not identify as “recreational users” so may miss the important messages about using clean needles. If you are a steroid user it’s vital to remember the importance of using clean needles for every injection and to never share equipment. HIV stands for human immunodeficiency virus. This virus, when transmitted into the human body, causes HIV infection, which is known to destroy the complete immune system of the person. This makes the body susceptible to illness and thus it gets very difficult to fight off the infection. Eventually, the last stage of HIV infection is AIDS.

The HIV can spread in three ways:

Contaminated Blood transfer
Intimate sexual relations
Use of syringes and needles that are contaminated.

The HIV could also spread to the baby from an infected pregnant woman. People with HIV infection show no symptoms even up to 10 years of being infected; however, they can pass the virus on to others during this period. The HIV Western blot tests and HIV ELISA detect antibodies in the blood. These antibodies work against the virus. If there are antibodies present in the blood stream, it indicates that you are body has the HIV virus within it. In the event of the test being negative, the presence of the antibodies is also negated and it would mean that you are not infected with HIV. However, you will have to take the test once again in three months. If the HIV western blot tests and HIV ELISA then show positive, it means that there are antibodies present in your blood stream. At this point, further tests must be done to determine the level of HIV present in the bloodstream. For the treatment of HIV infection, doctors recommend drug therapy. However this is for patients who have been taking their medications regularly and have a CD4 count of below 500 cells/mL. Some people, such as pregnant women and people with kidney problems caused by HIV may need to go through treatment regardless of their CD4 count.

It is very important that people with HIV take all doses of their medications. If they don’t, the virus will become resistant to the drugs. There are various types of anti-viral drugs used in therapy. In infected pregnant women, treatment is done to reduce the chances of transmitting the virus to the baby.

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). The HIV retrovirus may be passed from one person to another when infected blood, semen, vaginal secretions or other bodily fluids come in contact with an uninfected person's broken skin or mucous membranes. People with HIV have what is called HIV infection and are fit and well. Some of these people will develop AIDS as a result of their HIV infection. Growth hormone is a popular bodybuilding and performance enhancing aid, and the use of recombinant human growth hormone (rHGH, or simply GH) to treat various conditions in HIV infection has been debated with excitement for years. Indeed it is licensed for the treatment of wasting syndrome in advanced stages of AIDS. GH is also a commonly used bodybuilding and performance enhancing drug, which can be purchased on the black market, used to help both muscle anabolism / strength and reduction in body fat levels. Both of these applications have possible significance in the treatment of HIV.

Other than in the treatment of wasting disease, results from the studies using rHGH to treat body changes associated with HIV and/or drugs used to treat HIV have been very favorable. One which has been studied extensively is the use of rHGH in reducing HIV-associated adipose redistribution syndrome (HARS). However, the positive effects of HGH treatment in HIV may be more direct. Several studies have proposed that rHGH may bolster the immune system in ways that might improve clinical outcomes in HIV. Like cancer cachexia, advanced stages of AIDS are characterised by severe muscle wasting and weakness. The reasons for this are because the patient often has a very poor appetite and food intake, as well as there being direct wasting effects from the HIV and some associated diseases which the patient may have, e.g. pneumonia. The patient then enters a downward cycle with diminished strength, poor food intake and further wasting, and it's often this which leads to eventual death. Both anabolic steroids (AS) and rHGH therapy are used clinically to both slow the effects of wasting and to help improve appetite. Both have been shown to prolong life significantly and improve quality of life in advanced stages of AIDS.

HIV-associated adipose redistribution syndrome (HARS):
HARS is a type of lipodystrophy (abnormal distribution of body fat), where there is accumulation of excess truncal fat and visceral adipose tissue, as opposed to regular gynoid (glutes and hips) or android (abdomen) deposition. This is observed in HIV infected people, moreso as virus load increases. Although not a debilitating condition in itself (indeed extra body fat can prolong life if followed by wasting), HARS is unpleasant for the individual, giving reduced confidence in body image, another negative aspect of the disease.

rHGH therapy has been shown to significantly reduce HARS, leading to an improved body image, and significant improvement in psychological well-being. Numerous studies have demonstrated the benefits of this, leading to rHGH being licesenced for the treatment of HARS in some countries. It should also be noted that improvement in psychological well-being could also contribute to a positive clinical outcome, in that it reduces the effects of wasting.

Non-HIV-related illnesses – hepatitis
    Hepatitis B
    Hepatitis C
    Liver transplants
    Hepatitis A

Hepatitis means inflammation of the liver. The liver is the largest internal organ in your body. It is located at the upper right-hand side of the abdomen. Having a healthy liver is important for everybody, but it is especially important for people with HIV. The liver plays a vital part in processing medicines used to treat HIV and other conditions. Viral infections that affect the liver, such as hepatitis A, hepatitis B and hepatitis C, can make you ill and also mean that the liver is unable to process medicines properly.

Co-infection with hepatitis B virus or/and hepatitis C virus is increasingly becoming a cause of illness in people with HIV. Both these viruses affect the liver, can make you very ill and can be fatal. However, it is also possible to recover from these conditions spontaneously, and for them to be treated. Hepatitis B virus (often known as HBV) is common in some of the communities affected by HIV in the UK, as it can be contracted in the same ways as HIV, particularly through contact with blood, semen or vaginal fluid, and from mother to baby. It is possible to clear HBV without treatment, through the response of the immune system. If this does not happen (which is the case for about 10% of people), the infection can remain for many years and become ‘chronic’. People with HIV are more likely to develop chronic hepatitis B. HBV can cause severe or even fatal damage to the liver. Long-term infection with hepatitis B can cause liver cancer, and rates of liver cancer in people with HIV are elevated because of hepatitis B and hepatitis C. However, you may not have any symptoms at all for many years. During this time, it is still possible to pass HBV on to others. Using condoms correctly, every time you have sex, can protect against hepatitis B if you have a detectable HBV viral load. HBV can also be passed on through saliva, unlike HIV. You should be tested soon after your HIV diagnosis for hepatitis B, to see if you have been infected with the virus. If you have had a previous infection, and have recovered from it, you will then be immune to HBV. A vaccine is available to protect you against hepatitis B. If you don’t have the virus, and a test shows that you do not have natural immunity against it, it is recommended you are vaccinated against it. It is now recommended that all people with HIV, who have never had HBV, should have an annual test to check their immunity levels and be offered a booster vaccine if their immunity level has dropped below protective levels since their last vaccine. Your regular HIV monitoring involves checking the health of your liver. If you are co-infected with hepatitis B, this becomes even more important. Your healthcare team will regularly monitor your liver function using blood tests. Ultrasound examinations may also be performed, particularly if your liver shows signs of damage. Treatments are available for hepatitis B. These include antiviral drugs such as  adefovir (Hepsera) and interferon alpha. Some  anti-HIV drugs also work against hepatitis B. These are 3TC (lamivudine, known as Zeffix when used to treat hepatitis B and Epivir when used to treat HIV), tenofovir (Viread) and FTC (emtricitabine, Emtriva). Tenofovir and FTC are available in a combined pill called Truvada. There is conflicting evidence about the impact of hepatitis B on the progression of HIV disease. Anti-HIV drugs can be used safely and effectively in people with hepatitis B. However, when some people start HIV treatment, they experience a short-term flare-up of hepatitis B. This is because the immune system is getting stronger and is fighting hepatitis B. Some doctors try to stop these flare-ups happening by starting treatment for HIV and hepatitis B at the same time. Because of the risk of developing drug resistance, you should only take anti-HIV drugs that are effective against hepatitis B as part of an HIV treatment regimen. Nor should you take adefovir unless you are taking HIV treatment because of a risk of resistance.  If you are going to take treatment just for hepatitis B (and not for HIV), you should take interferon alpha. Which drugs you are treated with will depend on your CD4 cell count and whether you already need HIV treatment.

Muscle Pain or Myositis in HIV-infected persons

HIV-infected patients may present with muscle pains. It is important to examine

Muscle problems in HIV-infected persons include idiopathic polymyositis, polymyositis secondary to AZT toxicity, and pyomyositis. Weakness in the shoulder or hip girdle muscles, along with an elevated level of creatine phosphokinase (CPK) or aldolase or both, suggests polymyositis. AZT-induced polymyositis is similar to the idiopathic form, with muscle weakness, elevated CPK levels, and on muscle biopsy, myofibril necrosis with scant inflammation. In most cases, the patient improves gradually when AZT is discontinued, and the CPK level returns to normal.

Pyomyositis refers to solitary or multiple muscle abscesses that are not formed by local extension from superficial subcutaneous tissue. Although originally reported only in tropical climates, a number of cases were more recently described recently in North America, usually in healthy subjects but also in immune compromised hosts. The quadriceps muscle is most commonly involved, and 75% of patients have a single abscess.

Patients present initially with fever, and localized muscle pain. If the abscess is not deep in the muscle, redness, swelling, and a gradually developing woody induration may occur. If a painful area is found in a muscle during a physical examination, ultrasound, computed tomography, or magnetic resonance imaging is helpful in identifying and localizing the abscess or abscesses and in providing guidance during needle aspiration for identification of the pathogenic organism. S. aureus is responsible for the infection in the majority of cases, although a number of other bacteria have been recovered, including Escherichia coli and Salmonella enteritidis. After the area of the infection is defined, a diagnostic aspiration of the mass can be done under ultrasonic guidance. Systemic antibiotics usually cure a single small abscess, but large or multiple loculated abscesses often require surgical incision and drainage. Psoriatic arthritis with or without psoriasis occurs in HIV-infected persons. The prevalence of psoriasiform skin changes and psoriatic arthritis in HIV-infected persons probably is the same as that in non-HIV infected persons (1 to 2%), but the severity of the HIV-associated psoriasis and psoriatic arthritis tends to be worse. The foot and ankle are the most common, as well as the most severe, sites of inflammation in HIV-infected patients with psoriatic-like arthritis. Intense enthesopathy and dactylitis, especially in the feet, usually accompany the arthritis. The enthesopathy can be a major cause of disability. Frank synovitis and synovial effusions are less common, but can occur at the ankle and subtalar, metatarsal phalangeal, and interphalangeal joints of the feet. Sacroiliac and spine involvement may also occur. The radiologic appearance of these joints may mimic classic psoriatic arthritis, with "pencil and cup" deformities and osteolysis, even in the absence of frank psoriasis.

Nail involvement is a common presenting symptom of arthritis, especially in the distal interphalangeal joints of the hands and feet. Many patients with psoriatic skin manifestations or onycholysis have only these musculoskeletal findings and do not meet the criteria for a diagnosis of psoriatic arthritis. Nail involvement occurs in most patients who present with inflammatory articular symptoms. There is a high clinical correlation between skin and joint involvement, and joints may develop erosive changes and crippling deformities. Patients with HIV infection and psoriatic arthritis fall into one of two patterns of disease: either the articular disease is sustained and aggressive, progressing to joint erosions, or it is characterized by mild and intermittent joint involvement.
It is unknown whether HIV-associated psoriatic syndromes are strictly analogous to idiopathic psoriatic arthritis in non-HIV infected patients. Evidence against this possibility is that none of the human leukocyte antigen (HLA) alleles found in patients with idiopathic (non-HIV) psoriasis vulgaris or psoriatic arthritis (such as Cw6, B13, or B17) occur with greater frequency among HIV-infected patients with psoriatic-like arthritis.
The treatment of spondyloarthropathy in HIV-infected patients is similar to that for non-HIV infected patients. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin (75 to 150 mg per day), can be used initially for the joint symptoms, but results have been disappointing. There are few data on second-line agents such as gold, methotrexate, and azathioprine. There are reports that phenylbutazone (100 mg 3 times per day) is an effective drug for this arthritis, and neutropenia has not been a problem even in patients receiving AZT concurrently.

Patients in whom psoriatic skin or joint disease does not respond to NSAIDs may be treated with phenylbutazone (100 mg 3 times a day) or sulfasalazine (1 to 2 g per day). Etretinate may also be helpful. The use of psoralen and pulsed UV actinotherapy (PUVA) has helped the skin and joints of some HIV-infected individuals with psoriatic arthritis.

At our institution, treatment of patients with severe arthritis with low doses of methotrexate (5 to 10 mg per week) has led to rapid (< 4 weeks) improvement in inflammatory joint symptoms as well as improvement in skin lesions. Methotrexate can be given until the skin and joint disease is under control, then slowly tapered by 2.5 mg per month, aiming for a maintenance dose of 5 mg per week. Patients must be monitored closely, because there are anecdotal reports of progressive immunodeficiency and opportunistic infections in HIV-infected individuals with Reiter's syndrome who are treated with methotrexate. Systemic glucocorticoid use is generally discouraged because of increased risk of infection, but intra-articular steroid injection (every 4 to 6 months) may provide substantial relief to individual arthritic joints.
the patient to determine whether weakness accompanies the pain, and whether the pain is generalized or localized to one muscle group; localized pain may be a sign of polymyositis, whereas generalized pain suggests a systemic process. It is also important to determine whether the patient is taking zidovudine (AZT), and whether the muscle pain began soon after initiation of the drug therapy.

Anavar to treat severe weight loss

Anabolic steroids can be used to help patients regain weight after surgery, or to treat chronic infection or trauma. The drug has also been used by the bodybuilding community to increase muscle mass and decrease visceral fat. These steroids are thought to work in the body like artificial testosterone.

Potential mild side effects associated with taking Oxandrolone may include nausea, vomiting, and headache. More severe side effects, including trouble urinating, breast swelling, and prolonged erections, have also been noted. When taken for bodybuilding purposes, side effects, like reduced erectile function, increased anger, and anxiety may result. Severe side effects should be reported to a physician immediately. Patients prescribed Oxandrolone should fill out a complete medical history before taking the drug. A medical history of kidney problems, high blood pressure, and all types of cancer may affect the decision to prescribe Oxandrolone. Blood sugar levels may be decreased when taking Anavar or Oxandrin, so diabetic patients should be wary of taking the medication.

Interactions with other medications may increase health risks associated with taking this anabolic steroid. Corticosteroids, blood thinners, and certain herbal supplements can negatively interact with oxandrolone. Taking corticosteroids with Anavar or Oxandrin may increase the risk of heart failure or edema. In the bodybuilding community, oxandrolone is often taken as an oral cutting agent. These are thought to increase muscle hardness, maximize lifting strength, and decrease body fat. Taking oxandrolone without a prescription for bodybuilding purposes is illegal in the United States.

As an anabolic steroid, Oxandrolone is considered mild. High doses are typically prescribed to deter wasting, or weight loss, associated with disease. AIDS patients, for instance, can be prescribed 20 to 80 milligrams (mg) to counteract weight loss. Bodybuilders typically take 100 mg or more to achieve optimal cutting effects. Such steroids are typically cycled in and out of a bodybuilding diet. Cycles may include eight to 12 weeks on the drug, followed by several weeks off, before restarting them. These drugs are often stacked, or taken in conjunction, with other supplements or medications.

Psychological dependence has been noted in the bodybuilding community. During the on cycle, increased muscle gains and energy may leave bodybuilders feeling powerful. During off cycles, gains tend to reduce or cease all together and energy may wane. These negative effects on muscle and energy can lead to drug abuse. Anavar was originally developed to treat severe weight loss and has was prescribed for muscle wasting diseases, including AIDS. It was found that dosages of 5-10 mgs a day gave good results. But the prevention of muscle wasting and muscle building are two very different things.

Of course, as with ANY oral steroid once you go too far beyond 50 mgs or so, that’s when the potential problems begin. However, Var is thought of as less toxic to the liver than most other orals. Unfortunately, that belief is complete myth. Once again, the studies on the low toxicity of Var were done with the recommended dosages for medicinal purposes. Naturally, at 2.5 – 5 mgs a day one can expect no impact on the liver at all. This skewed evaluation falls under the category known as “bro-ology science.” In other words, someone does some reading, learns a little scientific knowledge, upon which he draws an seemingly reasonable yet erroneous conclusion, which in turn is then parroted endlessly from one so-called “expert” to another and on to a legion of followers. And on and on it goes. Before long, it’s considered common knowledge. Don’t be fooled. Anavar is 17 alpha alkylated , which in simple terms means that it is formulated to prevent breakdown in the liver. This makes for a greater effect but puts a tremendous strain on the liver. THAT is the main problem with orals, NOT the toxicity of the substance itself . And that is why Var in effective dosages should be regarded as hepatotoxic as most other oral steroids. Var can be stacked with any other steroid and can provide a welcome addition to any cycle. If you’re a newcomer to steroids and decide to use Anavar by itself, you can put on some solid muscle just don’t expect overnight gains. Var increases anabolism tremendously, which essentially means it allows the muscles to absorb more protein. So the muscle building process is intensified but keep in mind, it still takes some time to grow muscle . People often confuse actual muscle growth with a steroid taking time to kick in, when in fact it begins working immediately, it’s just that muscle growth takes time to show. You probably won’t notice much at all until the third or fourth week. This is where Var is too often underestimated. Since the effect is strictly of an anabolic nature, the muscle grown on Var is usually very solid and long lasting. It’s fair to expect up to five pounds of pure muscle from using 25 mgs a day for a month. That may not seem like a lot. When using steroids, people expect to see those numbers on the scale go up (even if it’s temporary or from water weight). That won’t happen with Var which is why many consider it weak. But imagine five pounds of meat spread out throughout your body. That’s a good amount of lean mass.

Anavar is not considered a good drug for “bulking” for the fact that it doesn’t cause water retention, nor does it increase blood volume. (Something dianabol does to a great degree). Therefore, there is no significant weight gain. But Var does increase strength dramatically, due in part to the increase in creatine production and utilization which increases contractile strength, so it can be a great asset to a bulking program where lifting heavier weights is paramount to gaining size. Don’t surprised if your bench goes up 20% within a few weeks. That’s how powerful it truly is.

Var is often compared to Winstrol since both produce very “dry” gains, but the two drugs are nothing at all alike. Winstrol is a derivative of DHT , therefore it’s most androgenic and has masculating sides effects. (Hair loss, increased body hair, tougher skin, etc). Var has almost no androgenic properties. This is another advantage in that Var doesn’t cause a hard shut down of the HPTA. Though like all steroids, its structure is based off of the testosterone molecule, there’s bound to be some suppression, but it will be minimal with Var. So if you want to give your cycle some “kick” without stressing the HPTA, or if you’re a first or second timer and want to take something that won’t be that hard to recover from, Var is an excellent choice.

Because Var doesn’t cause much water retention high blood pressure shouldn’t be a problem. Because of its mild androgenic nature, it does not “aromatize.” Aromatization is when the body gets flooded with too much androgen and converts some of it into estrogen. That causes bloating, acne, and a possible loss of libido. Due to its low androgenic profile, Anavar is a favorite among women. They can gain muscle without the fear of masculizing side effects such as excess body hair. Excess estrogen is not a problem with Var and that too appeals to women going for a leaner more defined look. 5-10 mgs a day are as far as a gal may want to push it though. Too much more than that and the risk/benefit starts to tilt in an unfavorable direction.

Discovery of Human Immunodeficiency Viruses

The identification of HIV-1 as the causative agent of acquired immunodeficiency syndrome (AIDS) just 3 years after the clinical syndrome initially was described represents a remarkable scientific achievement that had its roots in earlier discoveries of animal and human retroviruses. The selective loss of CD4+ helper T lymphocytes in patients with the disease implicated an agent with T-lymphocyte cell tropism. As expected for an etiologic agent, HIV-1 was shown to be uniformly present in subjects with AIDS and to reproduce the hallmark of disease, destruction of T lymphocytes, in tissue culture.

General Biologic Properties of HIV-1:
Soon after its discovery, HIV-1 was shown to be biologically, structurally, and genetically distinct from human T-lymphotrophic virus I (HTLV-I) and HTLV-II and more like members of the lentivirus subfamily of retroviruses.

Unlike the leukemia viruses, which lead to immortalization of lymphocytes in vitro and in vivo, HIV-1 exhibits pronounced cytopathic properties for lymphocytes, causing syncytia formation and cell death. Morphologically, HIV-1 differs from HTLV-I and other type C oncogenic retroviruses in exhibiting a dense, cylindrical core surrounded by a lipid envelope typical of lentiviruses.

Like all retroviruses, HIV-1 is a single-stranded plus-sense RNA virus. The RNA-dependent DNA polymerase, or reverse transcriptase, is packaged within the virion core and is responsible for replicating the single-stranded RNA genome through a double-stranded DNA intermediate, which in turn serves as the precursor molecule for proviral integration within the host cell genome. The major structural core proteins of HIV-1 are the p24 capsid protein and the p18 matrix protein, as shown. Surrounding the viral core protein structures is a bilayered lipid envelope that is derived from the outer limiting membrane of the host cell as the virus buds from the cell surface during replication. Studding this outer viral membrane are the envelope glycoproteins, gp120 and gp41, which are encoded by viral-specific genes and are responsible for cell attachment and entry.

Features of this life cycle distinguish retroviruses from all other viruses. The cell-free virion first attaches to the target cell through a specific interaction between the viral envelope and the host cell membrane. The specificity of this interaction between virus and cell has been shown to be due to a high-affinity specific interaction between the viral gp120 envelope glycoprotein and the target cell-associated CD4 molecule. Following virus adsorption, the viral and cellular membranes fuse, resulting in internalization of the nucleoprotein viral complex. Reverse transcription catalyzed by the viral reverse transcriptase generates a double-stranded DNA copy of the viral RNA within the nucleoprotein complex, and this migrates to the nucleus where covalent integration of viral DNA into the host chromosomes leads to formation of the provirus. Subsequent expression of viral DNA is controlled by a combination of viral and host cellular proteins that interact with viral DNA and RNA regulatory elements.

Transcribed viral mRNA is translated into viral proteins, and new virions are assembled at the cell surface where genomic-length viral RNA, reverse transcription, structural and regulatory proteins, and envelope glycoproteins are assembled. Because the HIV-1 pro-virus is covalently integrated within the host cell chromosome, it represents a stable component of the host genome and is replicated and transmitted to daughter cells in synchrony with cellular DNA. Relevant to subsequent discussions of viral pathogenesis, the integrated provirus is thus permanently incorporated into the host cell genome and may remain transcription ally latent or may exhibit high levels of gene expression with explosive production of progeny virus.

HIV Positive - This Bodybuilder is Positive about Life

As Schwarzenegger wannabes pit muscle against muscle to win India’s top bodybuilding prize, among these combatants will be one individual who is competing against life itself. This is an inspiring story of the can-do spirit. He is HIV+ but he is also positive about life. If you meet Khundrakpam Pradipkumar Singh you might feel a tinge of sympathy about a man who might soon come to the end of the road. But for Khundrakpam the journey is just beginning. Even today there might not be a cure for the dreaded virus but this inspiring individual busts the myth that HIV+ means a date with mortality and despair. Pradipkumar, tested positive for HIV seven years ago. Today, seven years down the line he is a bodybuilder and one of the contenders for the Mr. India title. "I was into drugs and that is how I contracted the virus. There was pain, anguish and a deep sense of guilt. That is when I decided to channelize all my emotions into body building and maintaining a fitness level."He began bodybuilding in 2003 and along with retroviral therapy he turned to the gym. He won the state title in the 60kg category. Medals and title came his way and soon he was competing at the national level. A runner-up at the Senior Mr. India Challenge Cup provided him further motivation to look at the bigger horizon. For the ultimate national title in the sport, he has had to mortgage his sister’s gold jewelry to make the trip to Kolkata.
Khundrakpam summarizes his gung-ho spirit by saying,"I want to prove that HIV is not the end of the world. I want to be a role model for such patients and tell the world that WE CAN."His motivational journey has been recognized by his state government which made him the face of their AIDS campaigns as a brand ambassador. Despite being a household name in his state of Manipur, financial help has been difficult to come by. Though that has hindered his diet and preparations, it hasn’t blocked his vision and attitude.
Even as he has his sights set on winning the national crown he dreams of contributing to society one day.

Things about HIV/AIDS you didn’t know:
2.3 million people were HIV positive in India. The disease was found to be most prevalent in southern and northern states with Andra Pradesh and Manipur having the highest number of cases. HIV was more prevalent men than in women and was seen in people between 15-49 years of age. The good news here is that the survey found that the number of people infected with HIV has decreased by 50% in 2011. This World AIDS day, the theme is ‘Getting to Zero’ – zero new HIV infections, zero discrimination and zero AIDS-related deaths. So in order to help us all move towards that goal here are eleven things about HIV/AIDS that you might not have known. HIV stands for Human Immunodeficiency Virus. A person is termed to be HIV positive when they are found to be infected by this virus. As the disease progresses it eventually eats away at the immune system of the patient, causing a number of opportunistic infections to take hold along the way.  AIDS or Acquired Immunodeficiency Disease is a host of conditions that are associated with the loss of one’s immune system – according to the CDC when a person’s CD4 count is below 200 cells/mm3.  This is the most severe stage of the infection. HIV and AIDS are different and a person who is HIV positive does not necessarily have AIDS.

You probably knew that HIV originated in monkeys. But did you know that there are actually two types of HIV strains? Labeled as HIV 1 and HIV 2, these two strains have been found in chimpanzees and small African monkeys. HIV 1 is the more potent of the two strains and is what most commonly causes HIV infection.

Once a person is infected with HIV it takes at least 10 years for it to progress into AIDS. AIDS is the final or most severe stage of the disease when the immune system of the patient’s body has been compromised greatly. 

The symptoms of HIV/AIDS very often mimic the symptoms of other very common diseases like the common cold or flu. While a person infected with the virus may experience symptoms within 2-3 weeks of being infected it may take up to three months. There are also some people who may be absolutely asymptomatic. The common symptoms of the condition are fever, rash, chills, sore throat, rash, night sweats, fatigue, swollen lymph nodes, muscle aches and ulcers in the mouth.

The test for HIV involves either testing your blood or your saliva for the presence of the antigen against HIV. The problem with this test was that it could not pick up the presence of the antigen you a patient’s body until he/she started producing antibodies to the virus, which usually takes about 12 weeks.  Recently a new test has been devised that tests for the presence of antibodies against the virus. This is far more accurate and one can get the test done as soon as they think they have been infected. All you have to do is go to a nearby testing center and check if you have been infected by giving a simple blood test. The test is not painful and is completed in about 10 minutes. Many people believe that if an HIV positive person cooks for them or somehow their blood is ingested they can contract the disease. This is not possible, because the HIV virus – for all the havoc it creates in our body – is extremely fragile and cannot survive outside a host. More importantly it is essential that blood containing the virus enter a person’s blood stream, this requires a deep injection directly into the blood vessels. Another fact to consider is the HIV virus cannot stand excessive heat. Even the heat generated by the sun damages it, so if one were to bleed into your food and cook it, you are highly unlikely to contract HIV. And finally everybody has a mucosal lining on the inside of our mouth and nose. So when we eat the HIV virus will not be able to infect a person.

Nandrolone Decanoate Cycle for Bodybuilders

Nandrolone Decanoate is widely regarded as the most popular steroid used among athletes and others in the last several decades. It has gained a reputation for its ability to produce large muscle gains, relieving joint pain and enhancing the immune system. Those suffering from rheumatism claim they’ve benefited from using Nandrolone Decanoate cycles. This anabolic steroid is among the most widely used throughout the world as “Deca” is known for having a low risk of negative side effects as well as a very low chance of converting to estrogen in the body. When you compare the negative side effects with those risked by using testosterone, you will find that Deca has only a 20% chance of negative side effects. It poses a low risk of liver toxicity while promoting gains in strength and size and at the same time a reduction in body fat.  Over the decades athletes have been stacking it with basically every drug and claim to have received positive results. It has apparently proven itself to be a great “foundation” drug for any type of cycle.

In order for Deca to be effective it must be used in a cycle of at least 12 weeks. It should also be taken along with testosterone due to the body’s natural levels of testosterone dropping. When a Nandrolone Decanoate cycle ends, testosterone should continue to be taken in therapeutic doses. It is recommended that Proviron and/or Nolvadex be taken. All in all it seems to be a very safe steroid. Many consider it the best steroid to use overall for men when you add up the benefits and low risk of negative side effects. One of the most interesting benefits is for those suffering from HIV. Nandrolone Decanoate is considered a safe drug to use for increasing lean body weight as well as for improving the immune system of those with HIV.

Those using a Nandrolone Decanoate cycle usually inject it once or twice a week. Men usually use a dosage of 200mg – 800mg every week or two. It perform optimally in doses of 2mg per pound of lean bodyweight a week. While taking Deca an estrogen antagonist like Nolvades or Clomid should also be used for the first few weeks. This helps to stimulate the production of testosterone, although not immediately as it may take two weeks to take effect.

If preparing for an event or show it is recommended that bodybuilders combine Deca with Winstrol in order to substantially improve definition and muscularity. Nandrolone Decanoate can also be used as part of a bulk cycle since it’s an acceptable anabolic and will provide good results. Combining Deca with Dianabol has been a classic cycle for getting excellent muscle growth. Another option is to substitute a stronger androgen with something like Testosterone or Anadrol. When you combine Nandrolone Decanoate with Winstrol in the weeks and/or months prior to an event it can greatly improve your definition and muscularity. To add even more hardness and density to your muscles, you could add Trenbolone, a strong non-aromatizing androgen. But basically by undertaking the classic steroid with Dianabol cycle you can count on having excellent growth. For even greater results you could substitute an even stronger androgen like testosterone or Anadrol.

Nandrolone Decanoate is among the most widely used and popular steroid compounds used in the last several decades. The reason for this is due to the fact that Nandrolone Decanoate cycles produces large muscle gains, helps with joint pain and also enhances the immune system. Because it does not convert to estrogen to the extent that other steroids do, it has a lower risk of negative side effects. Deca is not totally without its risks, for example it must be taken over a minimum of 12 weeks in order to produce results. Furthermore it must be used with Testosterone due to the fact that the body’s natural production will drop.

One of the most common side effects is acne and water retention. It also doesn’t act very fast to build muscle plus the muscles built are not very dramatic. Because it is slow to activate in the body and has fairly mild properties it must be taken for a longer duration. Generally speaking users will gain muscle weight in about twice the length of time it takes to get the same results from using Testosterone in equal amounts. When using Nandrolone Decanoate it should be in a cycle timed to last 8 to 12 weeks as you will get slow, even gains in muscle mass. Deca users usually inject themselves once or twice a week, although it does remain active in the body for a lot longer.

Bodybuilding and how do you get tested for HIV?

Although there is some overlap, research has shown that women use androgenic anabolic steroids (AAS) for reasons that are often quite different from those of men.  Even more dissimilar are the risks and consequences associated with female steroid abuse.  It is clear that AAS use is not equally as dangerous for everyone.  For example, AAS are:  less dangerous for adult male elite athletes, than their non-athletic counterparts; still more dangerous for teenage boys whose bodies are not yet fully developed and by far the most dangerous for both women and girls, as the female body is simply not equipped for exogenous (external in origin) male hormones.

Many women erroneously believe that since men already possess greater testosterone levels, and are made bigger and stronger with AAS, that they require considerably more of these drugs to achieve similar results.  However, since muscle size and strength does not increase in a manner directly proportionate to the amount of male hormone within the body, this theory is categorically false.  In fact, studies have shown that women get considerable anabolic benefit out of dosages that are only a fraction of those needed by men.  Thus, even those women who detrimentally decide to risk their health by using male hormones have no business taking them in large quantities.


There are many reasons women begin using anabolic steroids.  Several female AAS users have muscle dysmorphia, a disorder in which a person becomes obsessed with the idea that he or she is not muscular enough.  Those who suffer from this condition tend to hold delusions that they are "skinny", “fat” or "too small" when they are often above average in musculature.  Dysmorphia is sometimes referred to as bigorexia or reverse anorexia nervosa, and is a very specific type of body dysmorphic disorder.  Muscle dysmorphia is NOT a simple obsession with working out or bodybuilding.  To be clinically diagnosed as muscle dysmorphic, a person must exhibit symptoms of the ‘type’ and ‘degree’ outlined within the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and not merely be overly interested in their physique or engaging in fitness behaviors that other people would consider excessive.  Some of the inclusion criterion for the disorder are:

    Constantly examining themselves in a mirror
    Becoming distressed if they miss a workout session or one of six meals a day
    Becoming distressed if they do not receive enough protein per day in their diet
    Taking potentially dangerous anabolic steroids
    Neglecting jobs, relationships, or family because of excessive exercising
    Having delusions of being underweight or below average in musculature
    Other Reasons

Of course AAS provide tremendous performance enhancement benefits, and though men garner the bulk of such scandals, professional and amateur women athletes also administer them for this purpose.  Although such abuse has gone largely unnoticed in mainstream society, this issue is becoming so prevalent that some organizations have taken overtly preventative measures.  For example, cafe press.com markets a “Without Steroids Women's” t-shirt to those who remain and support drug free athletics.

Every year, thousands of women are infected with HIV. Learn the facts. Teach the women in your family and community how to prevent and treat HIV. HIV is the virus that causes AIDS. A person with HIV is called HIV positive (HIV+).
HIV makes it hard for your body to fight off sickness.
HIV is spread through body fluids like blood, semen or breast milk.

You can get HIV when you:

    Have sex with a person who is HIV+ and do not use a condom
    Share needles or syringes (drug works) with someone who has HIV
    Get blood from a person who has HIV. Now all donated blood is tested for HIV. You can’t get HIV from giving blood.
Most women get HIV from having unprotected sex with men. Always use a condom every time you have sex.
You can’t get HIV from shaking hands, kissing, or sharing household items like forks or glasses with someone who has HIV.
The only way to know for sure is to get an HIV test.

    You cannot tell who has HIV just by looking at them. Most people do not show any outward signs when they first get HIV.
    A person can spread HIV even if he or she does not look sick.
There are three basic types of HIV tests:
    Blood – A small amount of blood is taken from your finger or arm.
    Oral – Fluid is taken from the inside of your mouth
    Urine – A small cup of urine is used.

Some HIV tests take 1-2 weeks to get results from a lab. Other tests called “rapid HIV tests” can give results in about 20 minutes. You can get tested at places like a doctor’s office, mobile health van, or health fair. There are also home HIV tests that let you test yourself.

Screening Tests for HIV Diagnosis and Treatment

If you're worried that you might have been exposed to human immunodeficiency virus ( HIV),  the virus that causes AIDS - it's important to get tested as soon as possible. Although the prospect of being diagnosed with the disease can be scary, today you can live a long and full life with HIV, especially if you start treatment early. Knowing you are infected can also help you take precautions so that you don't pass the virus to other people.

Several different tests are used to diagnose HIV infection. Other tests are used to select and monitor treatments in people who are living with HIV. This article covers both types of HIV tests.

You are at risk for HIV infection and should be tested for it if:
    You’ve had several sexual partners.
    You had unprotected sex with someone who is or could be HIV-positive.
    You have used injected drugs or steroids or shared needles or other equipment during drug use.
    You have had any sexually transmitted disease, including herpes, hepatitis, or TB.
    You have had sex for drugs or money.
    You’ve had sex with someone who has a history of any of the above - or with someone whose sexual history you don’t know.

There are several types of tests that screen blood (and sometimes saliva)  to see if you are infected with HIV.

Newer tests can detect the presence of HIV antigen, a protein, up to 20 days earlier than standard tests. This helps prevent spread of the virus to others and means an earlier start for treatment. It is done with a pinprick to the finger.

Here's a look at available HIV tests:

Standard tests. These blood tests check for HIV antibodies. Your body makes antibodies in response to the HIV infection. These tests can't detect HIV in the blood soon after infection because it takes time for your body to make these antibodies. It generally takes two to 8 weeks for your body to produce antibodies, but in some cases it can take up to six months.

In standard tests, a small sample of your blood is drawn and sent to a lab for testing. Some of the standard tests use urine or fluids that are collected from the mouth to screen for antibodies.

Rapid antibody tests. Most of these are blood tests for HIV antibodies. Some can detect antibodies in saliva. Results are available in under 30 minutes and are as accurate as standard tests.

Antibody/antigen tests. These tests are recommended by the CDC and can detect HIV up to 20 days earlier than standard tests. They check for HIV antigen, a part of the virus that shows up 2-4 weeks after infection. These tests can also detect HIV antibodies. A positive result for the antigen allows treatment to begin earlier and the patient to avoid infecting others. These are blood tests only.
 Rapid antibody/antigen test. One antibody/antigen tests delivers results in 20 minutes.

In-home test kits. These kits there are two available in the U.S. screen blood and saliva for HIV antibodies. You can buy them at your local store. The Home Access HIV-1 Test System requires a small blood sample that is collected at home and sent to a lab. The user, who may remain anonymous, can get results by phone in three business days. The Ora Quick In-Home HIV Test can detect HIV antibodies in saliva, if the antibodies are present (which can take up to 6 months). The user swabs the upper and lower gums of their mouths, places the sample in a developer vial, and can get results in 20-40 minutes. A follow-up test should be done if the result is positive.

HIV Screening Tests After Diagnosis:

While being treated for HIV, your doctor will perform several tests to monitor your health, determine when you need to start treatment, and check how well treatment is working. These include:

CD4 count. CD4 is a protein that lives on the surface of infection-fighting white blood cells called T-helper cells. HIV targets these immune cells.

To monitor the health of your immune system, your doctor will check your CD4 count -- the number of CD4 cells in a sample of blood. You should have your CD4 count tested every three to six months during treatment.

A normal CD4 count is more than 500 cells per cubic millimeter (mm3) of blood. The lower the CD4 count, the less your immune system is functioning, and the more likely you are to get infections. Your doctor will probably start treatment by the time a CD4 count is under 500 cells/mm3. If your CD4 count drops to below 200/mm3, you are said to have full-blown AIDS.

Viral load test. A viral load test measures how much of the HIV virus is in the blood. You want to have a low viral load because it means treatment is helping to control the virus. If your treatment is working effectively, the viral load should drop to an undetectable level in your blood.

You'll have your viral load tested two to four weeks after starting treatment, then every four to eight weeks until the viral load is no longer detectable. An undetectable viral load doesn't mean you're not infected just that the amount of HIV in the blood is too low for the test to pick up.

Anabolic steroids are another experimental treatment for lipodystrophy

Anabolic steroids are another experimental treatment for lipodystrophy as well as a standard treatment for HIV-related wasting. French researchers reported on a man receiving treatment with AZT/3TC who developed a buffalo hump and insulin resistance nine months after beginning treatment. He received intramuscular Testosterone Cypionate biweekly for four months and lost abdominal fat and gained lean muscle mass. Furthermore, studies have found that anabolic steroids produce weight and lean body mass increases in people with HIV-related wasting. Steroids may disguise the visible signs of lipodystrophy rather than stop or reverse loss of fat tissue.

A randomized study of Oxymetholone treatment in 92 individuals with weight loss due to HIV wasting or lipodystrophy found that the anabolic steroid had no impact on total body fat after 16 weeks of follow-up, although weight and muscle increased.

Despite the availability of highly active antiretroviral therapy (HAART), chronic, involuntary weight loss still remains a serious problem for some people living with HIV. Various alterations in energy metabolism and endocrine regulation have been found to cause loss of lean body mass (LBM) and body cell mass (BCM).

Previously studies in HIV-positive men undergoing androgen replacement therapy or treatment with recombinant human growth hormone (rGH) have shown partial restoration of lean body mass, but these treatments have been largely ineffective in eugonadal individuals.

Now researchers from the Universities of Essen and Bonn have shown that the anabolic steroid oxymetholone can be considered an effective treatment for eugonadal male and female patients with AIDS-associated wasting.

A total of 89 patients (79 men and 10 women: 69 gay/bisexual men, 12 intravenous drug users, 7 heterosexual contact, one transfusion recipient) were enrolled

Patients were randomized to receive either 100mg/day twice daily (BID) or 150mg/day three times daily (TID) or placebo for 16 weeks. Patients in the placebo group gained 1.0 kg compared to 3.0kg among those receiving therapy three times daily and 3.5kg among those receiving therapy twice daily.

Seventeen patients (19%) discontinued treatment during the double-blind phase of the study. Fourteen patients (16%) were lost to follow-up or discontinued for personal or unknown reasons. One patient in the Oxymetholone BID arm discontinued due to nausea and vomiting and two patients in the Oxymetholone TID arm discontinued due to elevated liver enzymes.

Significant improvements were noted in appetite and food intake, increased well-being and reduced weakness by self-examination. Recent research has found that higher LBM is significantly associated with better physical functioning and better general health perceptions as well as with fewer days in bed in men, though not in women. The most important adverse event was liver associated toxicity. Overall, 35% of patients in the TID arm, 27% of patients in the BID arm and no patients in the placebo group had a greater than five times baseline increase for alanine aminotransferase during the double-blind phase of the study.

Weight gain was observed after an average of two weeks. The initial increase was rapid until week 4, but body weight remained at the same level from this point on. There was no correlation between the extent of weight gain and age, sex or disease stage.

Only one female developed a self-reported clitoris enlargement, whereas changes in libido were similar across groups. Oxymetholone can be considered an effective anabolic steroid in eugonadal male and female patients with AIDS-associated wasting, with the twice daily 100mg/day regimen appearing equally effective as the three times daily 150mg/day in terms of weight gain, LBM and BCM, as well as being associated with less, but still significant liver toxicity.

Risk of invasive pneumococcal disease remains high for people living with HIV

The risk of cancer is increased twofold for people with HIV compared to individuals in the general population, Danish investigators report in the online edition of AIDS. But the increased risk was almost entirely due to higher incidence of smoking-related cancers and also malignancies caused by viral infections. The risk of other cancers did not differ between the people with HIV and people who did not have HIV.

“In the present study we found that the increased risk of non-AIDS cancer was largely confined to cancers associated with smoking and viral infections,” write the authors. “The risk of cancers that are not considered strongly related to smoking or viral infections did not differ between the HIV-infected and the background population, and the impact of immune deficiency was limited.”

Non-AIDS-related cancers are an increasingly important cause of serious illness and death among people with HIV. The exact causes are uncertain. However, possible explanations include high rates of smoking, a high burden of viral co-infections such as hepatitis C virus (HCV) and human papillomavirus and immune suppression caused by HIV.

Investigators from Denmark wanted to establish the proportions of cancers in people living with HIV attributable to smoking, viral infections, and HIV-related immune suppression.

They therefore compared the incidence of cancer between people with HIV and matched controls in the general population. Results were stratified according to smoking status and immune deficiency. Cancers were categorised as smoking-related, virus-related or 'other'.

The HIV-positive population consisted of 3503 individuals who received care between 1995 and 2011. Their average CD4 count at baseline was 450 cells/mm3. At the time of inclusion in the study, 77% were taking HIV therapy and, for 92% of follow-up time, the people with HIV were taking antiretroviral therapy.

The control population consisted of 12,979 individuals. There were 157 cancer diagnoses among the people living with HIV compared to 255 diagnoses among the controls. The overall incidence of cancer was twice as high in people with HIV compared to the controls (IRR = 2.0; 95% CI, 1.6-2.5).

The incidence of cancers related to viral infections was almost twelvefold higher in the HIV-positive population than in the HIV-negative controls (IRR = 11.5; 95% CI, 6.5-20.5). Incidence of smoking-related cancers was almost threefold higher among people with HIV (IRR = 2.8; 95% CI, 1.6-4.9). The risk of other cancers did not differ between the people living with HIV and the HIV-negative controls.

Incidence of smoking-related cancers associated with current smoking was significantly higher among the people living with HIV (IRR = 21.35; 95% CI, 2.88-158.5) than the controls (IRR = 4.12; 95% CI, 1.74-9.78). For the people with HIV, a lowest-ever (nadir) CD4 count below 200 cells/mm3 was associated with a more than threefold increase in the risk of lung cancer (IRR = 3.54; 95% CI, 1.00-12.59). No patients with a nadir CD4 count above 200 cells/mm3 developed a smoking-related cancer.

Smoking-related and virus-associated malignancies accounted for 23% and 43% of cancers diagnosed in the HIV-positive population. Virological cancers were rare in the controls. The fractions of all cancers in the HIV-positive population attributable to smoking and viral infections were 27% and 49%, respectively.

For cancer types considered associated with smoking, the proportion attributed to smoking was 91%. The proportion of virus-related cancers attributed to having HIV was also 91%.

For cancers not strongly related to smoking or viral infections, the proportion attributable to being HIV positive and immune deficiency were 0%.

Deca Durabolin highly effective drug

Deca Durabolin has an active life of 14-16 days and is detectable over a period of 16-18 months. Belonging to the category of anabolic-androgenic steroids and classified as a 2.16 anabolic steroid, Deca is a highly effective drug that is available in different forms such as creams, pills, capsules and gels. Medically, the drug is advised to stimulate immune system enhancements and offer dramatic relief to HIV/AIDS patients and even treat specific blood disorders as part of the adjuvant therapy. This steroid is used by sportsmen to benefit from the improved recuperation time between workouts, protein synthesis, and nitrogen retention. Nandrolone is the base hormone, but it is better known under the trade name Deca Durabolin, which contains Nandrolone Decanoate. This popular preparation takes the Nandrolone hormone and adds a Decanoate ester chain. This ester chain is attached during the manufacturing process and it serves dual purposes. The main purpose is to make the hormone oil soluble, so it can be put in an amp or multi-dose vial. The second purpose of this ester chain is to slow-release the steroid by keeping deca from interacting with androgen receptors until the ester chain is cleaved off by enzymes in your body. Since Nandrolone Necanoate cannot attach to an androgen receptor until enzymes in your body have cleaved off the Decanoate ester, it causes the steroid to slow-release into your system over many days. For medical use, the ester’s main function is to allow the hormone to be injected only once every 3 weeks. However, bodybuilders may inject Deca Durabolin weekly or as often as every three days.

Moreover, this steroid is admired as its use even for long anabolic steroid cycles does not result in side effects like oily skin, male pattern baldness, and prostate complications. If that was not all, Deca use is considered of great use to mask minor joint pain and old nagging injuries besides reducing the inflammation of soft tissues and promoting masculine (secondary sexual) characteristics, including growth of the vocal cords, testicles, and body hair. This steroid is commonly used in doses of 300-800 mg per week by men and 50-100 mg per week by women or in doses of 600 mg per week for 12-16 weeks by men for bulking cycles and 400 mg per week for 12-16 weeks by men in cutting cycles.

A popular Deca Durabolin cycle is all about using Dianabol-30 mg every day for week 1-3 and then 40 mg every day for week 4-6 and complementing it with Sustanon 250 mg every week for week 1-12, Clomid 50 mg every week for week 10-12, and Deca Durabolin-200 mg for the first week and then 300 mg per week for 2nd and 3rd weeks, and 400 mg every week for 4th and 5th weeks, and 300 mg every week for the sixth week. Overdosing or use of low grade or abuse of Deca Durabolin can lead to side effects such as may even cause heart attack, edema, prostate enlargement, menstrual problems, liver toxicity, liver damage, and gynecomastia (female-like breasts). It may even cause elevated blood pressure, shrinking of the testicles, bone age advancement, bad effect on cholesterol levels, increased aggression, oily skin, acne, clitoral hypertrophy, infertility, and sexual dysfunction.

Side Effects:   
Side effects with Deca are much less than other steroids such as straight testosterones.  In fact, people choose Deca for this reason.  It’s not toxic to the liver and not particularly toxic to other organs of the body, and it’s highly effective.  That makes for a potent muscle-building brew; one you can really sink your teeth into without the threat of a lot of consequence.  It’s not, however, totally without them. Knowing how vain most bodybuilders truly are, most are thrilled that Deca doesn’t have acne as a side-effect.  In rare cases, there will be slight breakout, but not among the majority.  Now, that’s when you take 400mg/week.  But like anything worth doing, Deca is worth overdoing.  Right in the neighborhood of 600-1000mg/week is what I’m talking about.  This is where side effects begin to emerge and where you need to be aware of what they are.  Attitude can get hostile, sex drive can be out of control, sperm production can be non-existent (with prolonged use) and headaches can prevail. Also, the more you take, the more water you’ll have just beneath the skin to smooth out your appearance.  It really depends upon how vain you are. 

Pain in people with HIV

Pain is experienced through a complex set of interactions between parts of the body where pain is located,  the central nervous system in the spine; and the brain. These interactions occur via signals that travel back and forth between these parts of the body to make a person aware of pain, its location and its intensity.

Types and levels of pain vary by individual and the respective stage of HIV infection.  Almost all people in very advanced stages of infection experience pain.

 The various types of pain include:
- Neuropathic pain: Pain that attacks the nervous system is very common, and felt by around 30 percent of people with AIDS. It particularly affects the feet, hands and face, and has a tingling, burning or numbing effect.
- Headaches: These vary in intensity and can result from a wide range of factors including muscle tension, stress, sinusitis, migraine, and infection of the nervous system.
- Gastrointestinal pain: This affects all areas of the digestive system including the throat, stomach and intestines. Mouth ulcers and cold sores also affect the lips which can make eating difficult.
- Chest pain: This can be caused by opportunistic infections such as tuberculosis and bacterial pneumonia.

Aside from creating discomfort and distress, pain can also be a major hindrance to living a productive, fulfilled life. People with HIV who experience pain may not be able to earn a living, care for their families, or take part in social activities to the extent they would were they not in pain. Friends and family too may have to divert time from other activities to care for their loved-one in pain. Pain and its effect on life can also lead to emotional problems such as depression and anxiety.

Pain relief should be seen as a vital component of HIV treatment itself. If painful side effects of antiretroviral drugs can be averted through effective pain control, people will be more inclined to adhere to their treatment, and will be able to stop the replication of HIV far more effectively. Additionally, a USA-based study found that people living with HIV who experienced pain were 50 percent less likely to attend their medical appointments. Assessment of pain should be carried out before and during the treatment of pain in order to effectively control the pain and amend the treatment, if necessary. The various assessments include physical checks that may identify a particular symptom as the cause of the pain; having the patient describe how and when pain is at its worst or best; and examining the patient’s medical and psychosocial history and background, including a history of substance use and abuse, that may influence subsequent treatment.

No one besides the individual can more accurately say how much pain someone is in and therefore the patient should be at the center of pain assessment:

When being assessed, patients can be asked to describe their pain intensity on a variety of scales including a 0-10 range with “0” being “No pain” and “10” being “Worst possible pain”; a descriptive scale with, for example, the patient describing their pain as “moderate” or “severe”; or simply on a line, with pain increasing further along the scale. Children or speakers of other languages may convey their pain by selecting from a series of illustrations depicting different levels of happiness or sadness.

The Brief Pain Inventory is widely used to assess pain. It asks patients not only to explain the location and intensity of pain, but also to describe how it interferes in seven areas of life including work, walking, mood and relations with others.

Effects of nutrition on HIV Disease progression

The links between HIV and nutritional status run both ways. It has long been known that weight loss strongly predicts illness or death among people with HIV. More recently it has been found that this applies even to people taking antiretroviral treatment. Losing as little as 3-5% of body weight significantly increases the risk of death, losing more than 10% is associated with a four- to six-fold greater risk. A Zambian study involving nearly 30,000 patients has shown that failure to gain weight six months after the start of antiretroviral treatment increases the chance of death ten fold when compared with those who gain over 10 kilograms.

Various micro nutrients have been linked to changes in the rate at which HIV infection progresses to AIDS. Low levels of vitamin A, vitamin B12, vitamin E and selenium seem to accelerate progression. The effects of other micro nutrients, however, are more controversial. One such example is zinc. Although zinc is essential for a healthy immune system, it has been shown to play a role in HIV’s replication cycle. 12 On the other hand, some scientists claim zinc delays HIV disease progression.
There is strong evidence that malnourished people are less likely to benefit from antiretroviral treatment. One study in Malawi found that patients with mild malnutrition (a low body weight for their height) were twice as likely to die in the first three months of treatment. For those with severe malnutrition the risk was six times greater than for those of healthy body weight. Researchers in Singapore have reported similar findings. A study in Zambia showed death rates in the first three months of starting antiretroviral treatment were highest (95%) among the most severely malnourished. This is not just an issue for developing countries for example a study of people receiving antiretroviral treatment in Sydney, Australia found that one in three did not have access to nutritious food, and one in five said they regularly went hungry.

Without food or the right nutrition, taking antiretroviral drugs can be so painful that people simply don’t. In a choice between taking pills with no immediate or obvious effect, and eating food to survive, food will almost certainly take priority every time. A health worker in Zimbabwe, where malnutrition is widespread, explained that taking antiretroviral drugs on an empty stomach is like digesting razor blades. The result is that many simply do not take them. In resource-poor countries, treatment in children is made more difficult because many children with HIV are severely malnourished. Very little is known about how best to treat such children and in particular whether it is best to start antiretroviral treatment before or after nutritional rehabilitation. The World Health Organisation recommends treating the malnutrition first, but stresses that “further research on these matters is urgently needed.”

The ways in which the body digests, absorbs and makes use of drugs are very similar to the ways in which it treats food, providing many opportunities for food-drug interactions. As explained later in this article, a number of foods and supplements are known to alter the effects of antiretroviral drugs. It is also possible that some micro nutrient deficiencies may make the drugs less effective, or may worsen side effects.
The chance of someone transmitting HIV is linked to the amount of virus in their bodily fluids, which is known as the viral load. In theory, micro nutrient deficiencies may increase viral load by enabling HIV to replicate faster, or by weakening the immune system. Similarly, someone whose immune system has been weakened by micro nutrient deficiencies may be more likely to acquire HIV. Research in this area has, however, been largely inconclusive. The strongest evidence links low levels of retinol (the animal form of vitamin A) in women’s blood with increased rates of mother-to-child transmission.

Poor nutrition may also affect the spread of HIV in a very different way: by altering sexual behavior. One study of two thousand people in Botswana and Swaziland found that women lacking enough food to eat were less likely to use condoms and more likely to engage in risky activities, such as exchanging sex for money or resources.

Dietary advice should be tailored to individual circumstances. However, in general the recommendations for people living with asymptomatic HIV infection are much the same as for everyone else, meaning a healthy, balanced diet. Only three differences are worth noting:

- Because people with untreated HIV tend to burn more energy, the total number of calories should be around 10% higher than the usual guideline amounts, and up to 30% higher during recovery from illness. The balance of fat, protein and carbohydrates should remain the same.
- Many experts recommend a daily multivitamin (usually without iron, except in menstruating women or people with iron deficiency).
- The World Health Organisation recommends vitamin A supplements every 4-6 months for young children living with HIV in resource-poor settings.

HIV positive people suffering loss of appetite may need to make an extra effort to ensure they are eating enough. Helpful suggestions include eating several small meals per day, taking exercise to stimulate appetite, possibly mashing or liquidizing food to ease swallowing, and seeking advice from a health provider or dietician.

If other approaches have failed to reverse wasting then doctors may recommend a liquid food supplement, an appetite stimulant, or resistance exercise to build muscle. Other possibilities include steroids and hormone treatments, though these can be expensive and have serious side effects.

Growth hormone reduces liver fat in HIV-infected patients

In a preliminary study, HIV-infected patients with excess abdominal fat who received the growth hormone-releasing hormone analog Tesamorelin for 6 months experienced modest reductions in liver fat a theme issue on HIV/AIDS. Patients infected with HIV demonstrate a high prevalence of nonalcoholic fatty liver disease, estimated at 30 percent to 40 percent. The issue is being released early to coincide with the International AIDS Conference.

In human immunodeficiency virus (HIV) infection, abdominal fat accumulation is associated with ectopic (out of place) fat accumulation in the liver. Nonalcoholic fatty liver disease (NAFLD) may progress to end-stage liver disease and liver cancer. To date, there are no approved pharmacological strategies to reduce liver fat. Takara L. Stanley of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues randomly assigned 50 antiviral-treated HIV-infected men and women with abdominal fat accumulation to receive Tesamorelin (n=28), or placebo (n=22), subcutaneously daily for 6 months.

The researchers found a modest but statistically significant decrease in liver fat with Tesamorelin. Hepatic lipid to water percentage (a measure of liver fat), decreased in the Tesamorelin group (median, -2.0 percent) compared with placebo (median, 0.9 percent). In addition, there was a significant reduction in abdominal fat: the average change was -9.9 percent with Tesamorelin vs 6.6 percent with placebo.

"The decrease in liver fat in this study suggests that strategies to reduce visceral adiposity merit further investigation in HIV-infected patients with NAFLD, a condition for which there are no approved treatments. Importantly, NAFLD is associated with visceral adiposity and other metabolic abnormalities in HIV," the authors write. AIDS is the sixth leading cause of death among people aged 25 - 44 in the United States. This is an improvement since it was the number one killer in 1995. At the end of 2010, an estimated 91,500 people in the UK were living with HIV. Of these, around 1 in 4 (22,000 in total) did not know they were infected.

The World Health Organization (WHO) estimates that around 34 million people in the world are living with HIV. The virus is particularly widespread in sub-Saharan African countries, such as South Africa, Zimbabwe and Mozambique.
AIDS is caused by HIV infection. The virus attacks the immune system leaving the individual susceptible to life-threatening infections and cancers. Common bacteria, yeast, parasites, and viruses that usually do not cause serious disease in people with healthy immune systems can turn deadly for AIDS patients. HIV is found in all the body fluids including saliva, nervous system tissue and spinal fluid, blood, semen, pre-seminal fluid, which is the liquid that comes out before ejaculation, vaginal secretions, tears and breast milk. Only blood, semen, and breast milk have been shown to transmit infection to others. The virus is transmitted by sexual contact including unprotected oral, vaginal, and anal sex and via transfusion of contaminated blood that contains HIV.

Another mode of transmission is sharing needles or injections with HIV infected individuals. A pregnant woman can transmit the virus to her unborn baby through their shared blood circulation, or a nursing mother can transmit it to her baby in her breast milk. HIV infection does not spread by casual contact, mosquitoes, touching or hugging.
Those at highest risk include injection drug users who share needles, babies born to mothers with HIV (especially if the mother had not received anti- HIV therapy during pregnancy), those engaging in unprotected vaginal or anal sex with HIV positive individuals, and those who received blood transfusions or clotting products between 1977 and 1985 (before screening for HIV became standard practice).

HIV infection may cause no symptoms for a decade or longer. At this stage carriers may transmit the infection to others unknowingly. If the infection is not detected and treated, the immune system gradually weakens and AIDS develops. Acute HIV infection takes a few weeks to months to become a non-symptomatic HIV infection. Then it becomes early symptomatic HIV infection and later it progresses to AIDS.

Deca Durabolin used effectively to treat muscle wasting associated with HIV

Deca Durabolin is the brand name for an injectable steroid originally produced by Organon in 1962. It contains the active hormone Nandrolone with the Decanoate ester. The Nandrolone hormone is highly anabolic and produces very few side effects when used in reasonable doses, the Decanoate ester is a fatty acid which slows its release into the body over several weeks.

Nandrolone is technically a derivative of testosterone but it is created by removing the carbon atom at the 19th position of the steran nucleus, which creates a completely different family of steroids (the 19nor-testosterone family). It is one of the most versatile steroids on the market today, and can be used successfully in both bulking and cutting cycles, while in the clinical setting it has been used effectively to treat muscle wasting associated with HIV and AIDS. Deca Durabolin doesn’t produce many estrogenic side effects due to its low rate of aromatization (metabolic conversion to estrogen via the aromatase enzyme). Its ability to improve collagen synthesis and bone mineral content  is highly prized by bodybuilders and athletes who may have nagging injuries or joint pains.

But it’s not just Deca’s healing attributes which have made it such a popular steroid; bodybuilders and athletes have found Deca Durabolin to be one of the best all-around steroids for gaining lean mass and we see this played out in various clinical studies also. Muscle gained with this product is very solid with minimal bloat, as long as dosages are kept reasonable.

Because Deca Durabolin is so popular, that it’s important to note that it is considered a very long acting steroid, but the research is very inconsistent regarding just how long lasting it is. In healthy, normal, men one study found an average half-life of 8 days (but the range was from 5 to 17 days) at a dose of 50 mg, while another study found an average half-life of 5.9 days at a dose of 200 mg, another found an average of 7.7 days at a dose of 100 mg, and a final study  looked at showed an average of 7.1, 11.7, and 11.8 days depending heavily on the dose being either 50 mg, 100mg, or 150 mg, respectively.

In a practical sense, people will still shoot Deca once a week, but I thought it was important to show that typical half-life charts don’t factor in every single dose or dose response.

And, to further complicate things, the milligram per milliliter concentration and location of injection site heavily determines the actual blood plasma concentration achieved by a single shot of Nandrolone Decanoate: gluteal shots of Nandrolone Decanoate give you higher blood plasma levels of the parent hormone, and more highly concentrated preperations (mg/ml) also give you a higher overall blood level – and will probably provide better results, all things being equal.

Practical Use: Deca-Durabolin is easily the most versatile anabolic steroid on the market today (testosterone just misses that mark by virtue of the fact that women need to avoid it). It can be used in cutting cycles as well as bulking cycles, depending on the other compounds (and diet) one chooses.

Deca Duaraoblin Side Effects: Deca is one of the most mild steroids on the market in terms of side effects. Men who are very prone to hair loss will sometimes experience this with Deca-Durabolin, and gynecomastia is possible with higher doses. The most common side effect experienced with Deca-Durabolin is sexual dysfunction, although most users simply stack it with testosterone and avoid this entirely.

Used By: Because it’s so versatile, Deca-Durabolin is used by athletes, bodybuilders, and powerlifters alike. Women have found it to be mild enough to use at low doses, and many champion physiques of both genders have been built with its use. The only people who would be well advised to avoid Deca are drug tested athletes, as Nandrolone metabolites are detectable in urine for up to 18 months after the last injection.

Deca Durabolin Dosage: For men, an average dose of Deca-Durabolin is in the range of 200-600 milligrams. In women, 50 milligrams is a much more reasonable dose, although I have seen women go up to 100 milligrams without experiencing intolerable side effects.

Deca Duraboline Cycle: Deca-Durabolin works well with virtually every steroid. A good cutting cycle could include Deca, Winstrol, and testosterone – while a good bulking cycle could include Deca, Testosterone, and Anadrol.