Megestrol acetate for treatment of cachexia associated with human immunodeficiency virus (HIV) infection

Cachexia is a common problem in patients infected with human immunodeficiency virus (HIV) and predicts a poor prognosis. The deleterious effects of malnutrition on immunity to infection are well recognized. Therefore, evaluation of nutritional status and treatment, if indicated, in persons with HIV infection may be particularly important. Recently, megestrol acetate, a synthetic orally active progesterone widely used for the therapy of advanced breast cancer, was reported to stimulate the appetite and produce weight gain. On the basis of this information, we initiated megestrol acetate therapy in persons with HIV infection and severe anorexia and weight loss to evaluate its tolerability and potential benefits.