Manuscript Topics

Severe wasting associated with chronic HIV infection was first described in East African patients as “slim disease” (SD) in 1985. Although HIV-related cachexia bears remarkable resemblance to the wasting seen in patients with cancer, major differences exist. The former almost invariably coincides with malabsorption and small intestinal histological changes characterised by villous atrophy, crypt cell hyperplasia. In contrast, the latter results from immune-mediated inflammation and treatment-related pathology. In addition, the weight loss observed in “Slim disease” differs from that seen in patients with cancer by its rapid progression and severity frequently exceeding 20% of baseline body weight. Prior to the advent of highly effective anti-retroviral therapy (HAART), there was a striking failure of AIDS patients to respond readily to treatment. Intensive nutritional therapy or successful systemic infection resulted only in transient body weight gain whereas protein rich supplements containing n-3 or omega-3, polyunsaturated fatty acids (n-3PUFA) and antioxidant vitamins, are known to reverse severe weight loss in cancers.

In this special issue, we explore the underlying pathophysiological mechanisms of weight loss in both conditions and the effect of treatment in reversing cachexia.

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