Effects of Recombinant Human Growth Hormone on Fat Distribution in Patients with Human Immunodeficiency Virus–Associated Wasting

Abstract

In light of current interest in recombinant human growth hormone (GH) as a treatment for fat distribution abnormalities, we retrospectively evaluated regional changes in fat and lean body mass in a subset of subjects who participated in randomized, double-blind, placebo-controlled trials of GH for treatment of wasting. Treatment with a pharmacologic dose of GH (0.1 mg/kg/day) resulted in significant and sustained increases in lean body mass and losses of fat in both the trunk and appendicular regions.

Counteracting muscle wasting in HIV‐infected individuals

“…Growth hormone administered at a dose of 0.1 mg/kg/day to HIV‐infected persons with documented wasting (>10% loss of ideal body weight) for 3 months resulted in significant increases in weight and lean body mass ( P< 0.001) [78,79]. Subjects who received the same dose for 6 months showed no difference ( P= 0.25) in lean tissue mass compared with those who received 3 months of growth hormone [79]. This dose also resulted in a significant improvement ( P= 0.039) in work output (cycle ergometer) after 3 months [78].…”

Interventions for body habitus changes associated with HIV infection and its treatment

“…Several studies using supra-physiologic doses of 6 mg of growth hormone every day decreased the trunk and visceral fat in patients with HIV infection; however, the benefits were transient and disappeared when the drug was discontinued, and the intervention was associated with frequent adverse events [17,18]. Lower doses for longer periods of time were tried in a large, randomized, placebo-controlled study with a very complex design [19•].…”

Lack of Effect of Recombinant Human Growth Hormone on the In Vitro Activities of Antiretroviral Drugs against Human Immunodeficiency Virus Type 1

“…In randomized double-blind placebo-controlled trials performed in the pre-HAART and HAART eras, recombinant hGH (r-hGH) was shown to increase total body weight and lean body mass and to decrease body fat content (9,15,17,20). These changes are associated with improvements in physical performance and quality of life (15,17,20). Although optimization of nutritional status and exercise may also provide benefits in many cases, treatment with hGH is an excellent option in patients with severe wasting.…”

“…Human growth hormone (hGH) increases lean body mass and muscle nitrogen retention and thus represents a potential approach to the treatment of AIDS-related wasting (9,13). In randomized double-blind placebo-controlled trials performed in the pre-HAART and HAART eras, recombinant hGH (r-hGH) was shown to increase total body weight and lean body mass and to decrease body fat content (9,15,17,20). These changes are associated with improvements in physical performance and quality of life (15,17,20).…”

“…Clinical studies in both the pre-HAART era (15,17,19,20) and the HAART era (11) have shown that r-hGH can be effective and well tolerated as therapy for AIDS-related wasting. hGH has anabolic effects, which result in an increase in lean body mass (6,10,14).…”