Steroid useful in HIV, dangerous to the healthy
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An oral anabolic steroid can restore the muscle and fat tissue often lost to HIV/AIDS, but the side effects highlight the dangers that steroids pose to healthy people who abuse them, according to researchers.
Their study of 262 HIV-positive men found that the steroid, called oxandrolone, helped treat the substantial weight loss, or wasting, that can arise as a complication of HIV/AIDS. After 12 weeks, men who took the oral drug everyday showed gains in both weight and muscle tissue.
The side effects of treatment included an increase in LDL, or “bad,” cholesterol, and a drop in “good” HDL cholesterol. Some men also developed signs of liver toxicity.
These side effects, say the researchers, highlight the dangers of healthy people abusing oxandrolone or other anabolic steroids to build muscle.
The study authors, led by Dr. Carl Grunfeld of the University of California San Francisco, report the findings in the Journal of Acquired Immunodeficiency Syndromes.
HIV wasting is a serious complication in which people lose a substantial percentage of their normal weight, leaving them weakened and more vulnerable to life-threatening secondary infections.
There are a number of therapies for wasting syndrome, but some—such as nutritional supplements and a drug called megestrol acetate—lead mostly to gains in body fat. Injections of growth hormone, another option for wasting syndrome, boost muscle mass, but actually decrease fat stores.
The difference with oxandrolone and other anabolic steroids is that they increase both lean tissue and fat, said Grunfeld.
In a person with severe HIV wasting, he told Reuters Health, these are clear advantages, and must be balanced against the side effects of cholesterol changes and liver abnormalities.
“But if you’re healthy and abusing (steroids) to build body mass,” he said, “those risks are quite serious.”
In particular, the unhealthy cholesterol changes can contribute to clogged arteries and heart disease.
“The likely increased risk of heart disease in normal, otherwise healthy people is disturbing,” Grunfeld said.
As for people with HIV wasting, Grunfeld noted that oxandrolone is not specifically approved for treating the condition—though doctors can still prescribe it for that purpose. He recommended that patients taking the steroid be monitored for changes in liver function; if there’s significant toxicity, they should stop taking the drug.
The study received funding from Savient Pharmaceuticals Inc., which markets oxandrolone as Oxandrin.
SOURCE: Journal of Acquired Immune Deficiency Syndromes, March 2006.
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