EFFECT OF DRONABINOL ON NUTRITIONAL-STATUS IN HIV-INFECTION

OBJECTIVE: To examine the effect of dronabinol (delta-9-tetrahydrocann abinol) on appetite and nutritional status in patients with symptomati c HIV infection and weight loss. DESIGN: Double-blind, randomized, pla cebo-controlled, crossover trial with two five-week treatment periods separated by a two-week washout period. Patients received dronabinol 5 mg twice daily before meals or placebo. SETTING: A university-based H IV/AIDS clinic and a large infectious disease private practice largely devoted to care of patients with HIV. PARTICIPANTS: Twelve HIV-infect ed patients who had had at least a 2.25-kg weight loss participated in the study. Five patients completed the protocol, and seven withdrew ( two because of drug intolerance, two because of disease progression, t wo because of noncompliance, and one because of experimental antiretro viral therapy). MAIN OUTCOME MEASURES: Main outcome measures included caloric intake, weight, percent body fat, serum prealbumin, and sympto m distress. RESULTS: During dronabinol treatment, subjects experienced increased percent body fat (one percent, p=0.04); decreased symptom d istress (p=0.04); and trends toward weight gain (0.5 kg, p=0.13), incr eased prealbumin (29.0 mg/L, p=0.11), and improved appetite score (p=0 .14). CONCLUSIONS: In a selected group of HIV-infected patients with w eight loss, short-term treatment with dronabinol may result in improve ment in nutritional status and symptom distress.