People with HIV who are treated with anabolic steroids

People with HIV who are treated with anabolic steroids to prevent AIDS wasting may realize modest gains in weight and muscle mass, a new review shows. 13 studies of adults period 24 to 42 with HIV, 294 of whom received anabolic steroids for at least 6 weeks and 238 of whom received placebo. The average weight grow in those taking anabolic steroids was nearly three pounds.

“The magnitude of weight gain observed may be considered clinically relevant,” said lead author Karen Johns, a medical assessment officer from the agency Health Canada. “One hopes there would be greater weight gain with the long-term use of anabolic steroids; however, this has not been proven to date in clinical trials.”
In the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and property of existing medical trials on a topic.

AIDS wasting, which leads to important weight loss in people with HIV, causes severe loss of weight and muscle and can lead to muscle weakness, organ failure and shortened lifespan. Researchers have extensive sought to reverse this common, destructive result of HIV with mixed success. The wasting stems from loss of the body’s ability to increase muscle and from low levels of testosterone. Anabolic steroids are synthetic substances similar to the male gender hormone testosterone that promote growth of skeletal muscle and the development of male sexual characteristics.

Although most recently in the news for their misuse by professional athletes, anabolic steroids have legitimate medical application for men with low testosterone and people with certain types of anemia. Two anabolic steroids available in the United States, Nandrolone Decanoate and Oxandrolone, have been used to help increase weight and muscle mass in little studies of people with wasting. Conversely, anabolic steroids use has been associated with increased rates of HIV in those who share needles or use nonsterile needles when they inject steroids. The HIV/AIDS program director at the Group Health Cooperative in Seattle, suggests that clinicians should obtain blood testosterone levels, “if an HIV-infected individual has had important weight loss, important fatigue or muscle wasting, and particularly if associated with a significant decrease in libido and erections. If testosterone is in the low or low-standard range then a trial of steroids could be tried. The individual and the clinician should decide what result would constitute a lucky trial: weight gain of 15 pounds, a 30 percent improvement in sense of well-being or a successful erection once a week.”