The Body Covers: The 3rd International Conference on Nutrition and HIV Infection
Growth Hormone (rhGH) and Fat Redistribution Syndrome
April 22-25, 1999
Several papers concerning growth hormone (rhGH) and fat redistribution syndrome were reported. Dr. Christine Wanke from Boston reported on improvement in fat redistribution syndrome in 10 patients treated with rhGH in an ongoing 12 week study. All subjects were receiving protease inhibitors, 3/10 androgens, 5/10 exercising. The measurements of waist-to-hip ratio declined while midthigh circumference increased indicating improvement in abdominal obesity and peripheral fat wasting. Neither lean body mass nor body fat changed. One patient had a recurrence of fat redistribution after completion of the 12-week treatment course.
Jill Cadman (associate of Dr. Ramon Torres) presented a summary of rhGH in 10 patients with fat redistribution syndrome-associated adiposity in New York. All of these patients were on HAART including a protease inhibitor. Most of these patients had truncal obesity, and 6 had buffalo humps. 9 of 10 patients showed improvement in fat accumulation with therapy, but every patient who stopped therapy had recurrence. Dose reduction was also associated with worsening of fat redistribution syndrome. Some of the patients have continued therapy for up to 24 months. Other reports on the use of rhGH were equally anecdotal but with even smaller numbers of patients. Growth hormone has shown beneficial effects in reducing the fat accumulation of HIV-associated fat redistribution syndrome, but its high cost and apparent necessity for long-term treatment will limit its application for this complication. All the reports so far using rhGH for fat redistribution syndrome have been anecdotal, uncontrolled and observational only. Unfortunately none of the potential treatments of fat redistribution syndrome have been studied in a controlled manner. Follow-up has been short in all of these studies.
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