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HIV Wasting Syndrome — SCE Infectious Diseases MCQ

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ModerateHIV MedicineHIV Wasting SyndromeSCE Infectious Diseases

A 40-year-old man with HIV develops wasting syndrome (>10% involuntary weight loss over 6 months with chronic diarrhoea and documented fever >30 days). All infectious workup is negative. He is on effective ART (CD4 350, VL <50). What is this condition?

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Correct answer: D — HIV wasting syndrome — an AIDS-defining condition that can persist even with viral suppression; management focuses on nutritional support, exercise, and addressing contributing factors

HIV wasting syndrome (>10% involuntary weight loss plus chronic diarrhoea or chronic fever >30 days without alternative explanation) is an AIDS-defining condition per WHO/CDC. It can occur even in patients on effective ART with viral suppression — reflecting chronic inflammation, altered metabolism, and intestinal dysfunction. Management: optimise nutrition (high-calorie, high-protein diet ± nutritional supplements), resistance exercise, treat any reversible causes (depression, OI, medication side effects). Testosterone replacement may be considered in hypogonadal men. Megestrol acetate (appetite stimulant) is occasionally used.

Reference: BHIVA 2022 – Wasting syndrome; WHO 2021 – HIV clinical staging