Effects of nandrolone decanoate compared with placebo or testosterone on HIV-associated wasting.

Objectives Current research is unclear about the most effective pharmacological agents for managing the loss of weight and fat-free mass common in HIV/AIDS. The aim of this study was to compare nandrolone decanoate with placebo and testosterone. Methods The study was a multicentre randomized double-blind placebo-controlled trial. Three hundred and three adult HIV-positive male patients with a weight loss of 5-15% in the last 12 months, or a body mass index of 17-19 kg/m(2), or a body cell mass/height ratio lower than 13.5 kg/m, were randomly assigned to receive nandrolone decanoate (150 mg), testosterone (250 mg) or placebo intramuscularly every 2 weeks for 12 weeks. Fat-free mass, weight, immune markers and perception of treatment were the main outcome measures. Results Treatment with nandrolone resulted in significantly greater increases in fat-free mass [mean increase 1.34 kg; 95% confidence interval (CI) 0.60; 2.08 kg] and in weight (mean increase 1.48 kg; 95% CI 0.82; 2.14 kg) compared with placebo. The mean increase in weight with nandrolone of 1.00 kg (95% CI 0.27; 1.74 kg) when compared with testosterone was significant, although the difference in fat free mass did not reach significance (mean increase 0.69 kg; 95% CI-0.13; 1.51 kg). Patient perception of benefit was significantly greater in the nandrolone group when compared with both the placebo and the testosterone groups. Conclusions Treatment with nandrolone decanoate increased body weight when compared with placebo and testosterone. Nandrolone decanoate treatment resulted in greater increases in fat-free mass than placebo and demonstrated a trend for a significant increase when compared with testosterone.

[Infectious mononucleosis.]. / Mononucleose infecciosa.

OBJECTIVE: To present updated aspects of the Infectious Mononucleosis caused by the Epstein-Barr Virus. MATERIALS AND METHODS: Research of bibliographic references through the Medline and direct research of selected papers. RESULTS: A concise approach to some aspects related to the epidemiology of the virus, namely the two types that are presently known,EBVtypeAandEBVtype B, and some differences that they present. It was possible to establish a relationship between what one sees in the clinical picture and the immunological changes that occur at the same time. The author also describes the physiopathology, clinical features, complications and other syndromes associated to the EBV. As far as the laboratory workup is concerned, it is important to have a complete blood count as the first step, followed by the quantitative exam of the heterophile antibodies and antibodies antiEBV analysis. CONCLUSION: The pathologies related to the EBV are important, and certainly fascinating from the immunological point of view. Among these, the Infectious Mononucleosis caused by the EBV has shown some interesting clinical and laboratorial aspects.