Growth hormone may help some HIV patients

The side effects of Aids drugs – including increases in belly fat, elevated blood pressure, and high triglyceride levels – are significantly reduced by very small doses of growth hormone, according to the results of a new trial.

However, the treatment raises glucose levels, which may limit the usefulness of the drug for HIV patients.

Dr Steven Grinspoon of Massachusetts General Hospital in Boston presented his group's results at the International Aids Conference on Sunday in Mexico City. The study is also published in the Journal of the American Medical Association.

Previous studies have shown that growth hormone deficiency is very common in HIV-infected patients with abnormal body fat distribution and excessive abdominal fat.

The current trial differed from previous growth hormone studies in HIV patients with treatment-related metabolic effects, Grinspoon told conference participants, because his group used much lower doses and the trial lasted much longer at 18 months.

The study involved 56 well-matched HIV-infected patients, all on stable antiretroviral therapy for at least 12 weeks. They had relative growth hormone deficiency and abdominal fat accumulation. The patients were randomly assigned to get injections with placebo or growth hormone, starting at 2 micrograms per kilogram of body weight per day to a maximum of 6 micrograms per kilogram per day.

After 18 months, abdominal fat had decreased by 8.5 per cent in the growth hormone-treated patients compared with a decrease of only 1.6 per cent in the placebo group.

Lower triglyceride and blood pressure levels were observed in the growth hormone-treated group, but there were no changes in cholesterol levels.

However, growth hormone therapy increased the blood level of glucose at 2 hours after a standard oral dose of glucose, indicating that the ability to process glucose was impaired.

"These data inject a note of caution into the debate regarding the use of growth hormone in HIV infection," Grinspoon noted. "Even low-dose growth hormone, albeit effective in improving major cardiovascular risk measures and better tolerated than high-dose growth hormone, may increase specific insulin parameters."

More research is needed to identify patients who may benefit the most from growth hormone.