Further evidence that anabolic steroids or resistance exercise (weight training) can help replace lean muscle tissue lost in HIV wasting appears in a study published in this week's edition of the Journal of the American Medical Association. However, using anabolic steroids with an exercise programme did not result in any greater benefit than using one element on its own.
61 HIV-positive men whose body weight had declined by more than 5% in the previous 6 months, and who had low serum testosterone levels (< 12.1 nmol/L (349 ng/dL) were randomly assigned to receive either 100mg testosterone enanthate weekly as an intramuscular injection or a placebo injection. They were also randomly assigned to a programme of resistance exercise or to maintain their normal activity levels.
Daily food intake was standardised for all four groups at 1.5g of protein per kg of body weight and 40kcal per kg of body weight, a diet very high in protein and carbohydrates
After 16 weeks, muscle strength had improved by 20-30% in all groups apart from the placebo group, and this improvement was statistically significant. Weight changes in each group are outlined below (asterisks indicate changes from baseline that were statistically significant):
Treatment group
Overall weight gain
Muscle gain
Placebo / no exercise
-0.5kg (ns)
+0.9kg (ns)
Exercise alone
+ 2.2kg *
+2.1kg *
Testosterone alone
+2.6kg *
+2.3kg *
Testosterone and exercise
+0.7kg (ns)
+2.6kg *
The authors cannot explain why the testosterone and exercise group failed to perform better than the exercise alone or testosterone alone group, despite the expected additive effect of combining the two interventions.
Reference
Bhasin S et al. Testosterone replacement and resistance exercise in HIV-infected men with weight loss and low testosterone levels. JAMA 283:6,763-770, 2000.