2008, Número 85
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Rev Enfer Infec Pediatr 2008; 21.22 (85)
Tratamiento con nandrolona en el síndrome de desgaste asociado a VIH en niños: revisión cualitativa de la literatura
Rodríguez GCA, Montijo BE, Bacarreza ND, Cervantes BR, Hernández BV, Zárate MF, García CM, Mora MI, Ramírez MJ
Idioma: Español
Referencias bibliográficas: 61
Paginas: 10-17
Archivo PDF: 217.95 Kb.
RESUMEN
Antecedentes: la pérdida de peso durante la historia natural de la enfermedad en pacientes con el síndrome de inmunodeficiencia adquirida (SIDA) y en la infección por el virus de inmunodeficiencia humana (VIH) es común y tiene un origen multifactorial. Las infecciones oportunistas como la misma infección por el VIH son responsables del incremento en el consumo de energía e hipermetabolismo, desencadenando desnutrición. La pérdida de peso en pacientes con VIH, aun en un pequeño porcentaje, se asocia con la progresión de la enfermedad y es un dato de mal pronóstico. El manejo actual de esta patología incluye un adecuado manejo nutricio, terapia física y medicamentos como esteroides anabólicos, megestrol, ciproheptadina y hormona de crecimiento recombinante humana.
Objetivo: Evaluar la eficacia y la seguridad de la nandrolona en pacientes pediátricos con síndrome de desgaste por VIH, analizando lo publicado o reportado en la literatura mundial.
Material y métodos: Se incluyeron ensayos clínicos aleatorizados y controlados, realizados entre 0 y 17 años y 11 meses de edad, en pacientes con diagnóstico de síndrome de desgaste asociado a VIH/SIDA, evaluando el tratamiento intramuscular con decanoato de nandrolona.
Resultados: No fue posible realizar metaanálisis, debido a la heterogeneidad de los resultados de impacto en los ensayos clínicos sobre la utilidad de la nandrolona en el síndrome de desgaste asociado a VIH/SIDA. No existen ensayos clínicos realizados en niños, por lo que esta revisión evaluó todos los ensayos practicados en adultos con decanoato de nandrolona en el síndrome de desgaste asociado a VIH/SIDA.
Conclusiones: A pesar del amplio uso de la nandrolona en adultos para el tratamiento del síndrome de desgaste asociado a VIH y otras enfermedades crónicas, de su eficacia y seguridad en la ganancia de peso, incremento en la masa corporal magra y masa libre de grasa no hay evidencia alguna para su utilidad en pediatría.
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