1st International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 26–28 June 1999 - San Diego, CA, USA

EFFECT OF RECOMBINANT HUMAN GROWTH HORMONE IN THE TREATMENT OF VISCERAL FAT ACCUMULATION INFECTION: INTERIM ANALYSIS

Antiviral Therapy 1999; 4(Suppl. 2):19 (abstract no. 6)

ES Engelson, M Glesby, J Sheikhan, J Albu, J Wang, SB Heymsfield and DP Kotler
St Luke's-Roosevelt Hospital Center, Columbia University, New York, New York, USA

BACKGROUND: The fat redistribution and metabolic alterations in HIV infection resemble the metabolic syndrome X, which is seen in non-HIV-infected people. Growth hormone therapy has been shown to promote loss of visceral fat in the metabolic syndrome X.

OBJECTIVES: To determine the safety and efficacy of recombinant human growth hormone, 6 mg once daily for 6 months, in HIV-infected subjects with fat redistribution and metabolic alterations.

DESIGN: Prospective open-label study with measurements at baseline, 3 months and 6 months. Outcome measures include visceral and subcutaneous adipose tissue (VAT, SAT), determined by whole body MRI, serum triglycerides and cholesterol, glucose tolerance and insulin sensitivity.

RESULTS: Thirty subjects, 26 men and four women have been accrued and are being followed. At baseline, both men and women had increased VAT (5.6±1.81), compared to SAT (14.4±7.7) with an average VAT:SAT of 0.39. After 3 months of follow-up, VAT had decreased by about 50% to 2.8±1.0 (P<0.005, n=8), while SAT decreased non-significantly to 13.4±8.0. Fasting serum triglycerides fell significantly by 3 months (342±214 to 276±163, P<0.005, n=20) and fasting glucose rose significantly (91±9 to 115±42, (P=0.02, n=20), while serum cholesterol did not change significantly (233±71 to 204±70). Joint stiffness and arthralgias were the most common complaints.

DISCUSSION: These results indicate that visceral adipose tissue is labile and decreases during therapy with growth hormone in HIV-infected people, as it does in those with the metabolic syndrome X. Therapy is not associated with exacerbation of hyperlipidaemia, though it did lead to some hyperglycaemia.

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