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Krentz Andrew J.; Roster, Frederick T.; Crist, Douglas M.; Finn, Kevin; Johnson, Leeanna Z.; Boyle, Patrick J.; Schade, David S.
Journal of Acquired Immune Deficiency Syndromes: March 1993
CLINICAL SCIENCE: PDF Only
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Metabolic and anthropometric changes induced by “pharmacological” versus “physiological” doses (5.0 vs. 2.5 mg, every other day) of recombinant human growth hormone (rhGH) were compared in 10 human immunodeficiency virus-positive patients with AIDS or AIDS-related complex. Five patients were randomly assigned to each treatment schedule in a 3-month prospective, double-blind clinical trial. Three of the 10 patients, none taking zidovudine and all with low initial CD4 counts, were withdrawn during the study due to acute opportunistic infections. During treatment, insulin-like growth factor-1 (IGF-1) levels increased significantly (p < 0.05) in the pharmacological hGH treatment group, whereas no significant change was observed in IGF-1 in the physiological dose rhGH group. In the pharmacological hGH treatment group, weight loss preceding the study was reversed (p < 0.05) in each of the four patients who completed the study. This weight gain was associated with increases (p < 0.05) in lean body mass and total body water, with concomitant decreases in fat mass (p < 0.05) and urinary nitrogen excretion. Muscle power and endurance, as assessed by standardized omnikinetic dynamometry, also improved. All four patients lost weight again (p < 0.05) 6 weeks after completion of the study and termination of rhGH treatment. Minor positive changes in body composition were also observed in the physiologicdose hGH group. The pharmacological dose of hGH was associated with minor increments (p < 0.05) in fasting plasma glucose, insulin, and C-peptide concentrations, which were of negligible clinical significance. No significant changes were observed in mean CD4 cell count, although one patient receiving the pharmacological dose became p24 antigen positive during hGH treatment. Our data suggest short-term beneficial effects of hGH in patients with AIDS and AIDS-related complex with reversal of weight loss and improvements in body composition and functional capacity. These results suggest the need for a controlled trial to study efficacy of rhGH in the management of wasting in patients with AIDS and AIDS-related complex.

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