Diarrhea, a frequent side effect of AIDS drugs, causes loss of calories and nutrients. Even before any symptoms show up, energy output is increased. This might be caused by the increased activity of the immune system. People with HIV need more calories just to maintain their body weight. Also, cytokines play a role in wasting.
Cytokines are proteins that produce inflammation to help the body fight infections.
People with HIV have very high levels of cytokines. This makes the body produce more fats and sugars, but less protein. For example, infections may increase the body's energy requirements. At the same time, they can interfere with nutrient absorption and cause fatigue. This can reduce appetite and make people less able to shop for or cook their meals.