4 in men with hypogonadism have all been approved for the treatment of the wasting syndrome [12]. Cytokine modulators (such as thalidomide) have been investigated for treatment of wasting syndrome, but their success rates have been variable [11, 12, 32]. Thus, they are not yet approved for the management of the wasting syndrome, until convincing evidence of their eﬃcacy is established in future studies. 4. Conclusion HIV wasting syndrome is a disorder characterised by mul- tiple pathophysiological mechanisms, most mediated by the HIV virus itself and driven by nutritional abnormalities. HAART treatment failure is an emerging global challenge, especially in developing countries where HIV infection is still endemic and the use of HAART is being scaled up [33]. A failing HAART regimen leads to HIV persistence and acting together with psychosocial issues such as poverty, it sets the stage for the re-emergence AIDS deﬁning illness such as the wasting syndrome. To prevent or reverse the resurgence of AIDS deﬁning illness such as the wasting syndrome in this HAART era, ensuring eﬀective uninterrupted HAART, socioeconomic empowerment of HIV-infected patients, and prevention of opportunistic infections are priorities for developing countries such as Nigeria. Author’s Contributions We declare that this work was done by the authors and all liabilities pertaining to claims relating to the content of this article will be borne by the authors. The ﬁrst author conceived the report; all authors were involved in patient management, manuscript preparation, and review, and they approved the ﬁnal version for publi- cation. Conﬂict of Interests No conﬂict of interests associated with this work. Ethics References Consent was obtained from the patient for clinical photos. 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