Use of recombinant human growth hormone in HIV-associated lipodystrophy.

OBJECTIVE

In the past few years there has been great interest in potential interventions for the body shape abnormalities in HIV-infected individuals that have been termed the HIV-associated lipodystrophy syndrome. This review examines the studies that have focused on the effects of recombinant human growth hormone as a treatment for the central fat accumulation that is part of this syndrome.

RESULTS

A recent placebo-controlled trial confirmed that growth hormone leads to a significant dose-dependent improvement in trunk or visceral fat. These improvements were accompanied by dose-dependent side-effects, including glucose intolerance/insulin resistance and tissue edema. With the improvements seen with growth hormone treatment, the patient's body image and sense of well-being also improved. Recent novel data suggest that the use of growth hormone-releasing hormone may possibly be an alternative to treating HIV lipodystrophy with recombinant human growth hormone, because it appears to have fewer adverse events and results in the same benefits in HIV-infected patients with central fat deposition.

CONCLUSIONS

Growth hormone has been shown to lead to a dose-dependent improvement in patients with HIV-associated visceral fat accumulation. Treatment with growth hormone has been complicated by predictable and dose-dependent side-effects. The optimal dose and duration of treatment with growth hormone is not known.