Recombinant human growth hormone improves the fat redistribution syndrome (lipodystrophy) in patients with HIV

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Abstract
To determine the efficacy of recombinant human growth hormone (rhGH) in the treatment of the fat redistribution syndrome (FRS) in patients with HIV. A prospective, open-label study. An urban, university-affiliated Infectious Disease Clinic. Ten HIV-infected patients (seven men, three women) with FRS. Treatment with 6mg of rhGH a day, subcutaneously for 12 weeks. Body mass index (BMI), body composition by bioelectrical impedance analysis (BIA), body composition by anthropometrics (including waist/hip ratio), buffalo hump. The mean age was 41.7 years, the CD4 cell count was 247, and the HIV RNA was 95735 copies/ml; 50% had undetectable viral RNA. The BMI was significantly increased from baseline to the end of treatment with growth hormone (25.3-26.9kg/m2; P<0.04); the waist/hip ratio significantly decreased from baseline levels, after treatment with growth hormone (1.03-0.9; P<0.04); mid-thigh circumference increased significantly when baseline was compared with measures after treatment (49.1-51.8cm; P<0.03). One patient had to discontinue therapy because of hyperglycemia. Short-term treatment with rhGH improved the alterations in body shape that occur with FRS in HIV-infected patients. Waist/hip ratios and mid-thigh circumference are useful measures to follow alterations in body shape in FRS.