• Growth Hormone Improves Appearance and Lean Mass in Lipoatrophic Patients and These Benefits are Maintained With Alternate-Day Dosing (Abstract H-1935)
  Authored by G. Moyle, C. Baldwin, B. Langroudi, B. Gazzard
  Poster Presentation: View the original abstract

For patients with HIV-associated wasting and loss of lean body mass, the use of recombinant human growth hormone (rhGH) has been shown to increase lean body mass (mainly muscle), and to decrease visceral adipose tissue (the accumulation of fat inside the abdomen). In some studies, rhGH has also been shown to modestly decrease the size of increased neck fat. However, fat under the skin in the arms and legs has been noted to decrease as well, a property of rhGH that could make its use in patients with severe loss of fat in the arms and legs problematic.

Dr. Moyle and colleagues in London studied the use of growth hormone in 12 patients (gender not noted) who had good response to antiretroviral therapy (nine on NNRTI and three on protease inhibitor-containing regimens) but peripheral lipoatrophy, or fat loss, based on an undefined clinical case definition. All patients were treated with daily injections of 4 mg of rhGH for 12 weeks and then were randomized to receive every other day, twice weekly or placebo for 12 more weeks of maintenance. Assessment of body composition was done with CT and DEXA scans at 0, 12, 24 and 48 weeks.

All patients had good increases in fat-free body mass over the first 12 weeks and decreases in total, visceral and trunk fat with no change in arm or leg fat, similar to reports from other studies. Over the entire 48 weeks of the study, there was a reported increase in arm and leg fat that was not statistically significant. The every-other-day and twice-weekly injection groups had stable limb fat, and the placebo group had an increase in limb fat over the entire period. Fat-free mass (muscle) was lost in the twice-weekly and placebo groups, but maintained in the every-other-day group. Patients' self-assessments of limb and facial appearance improved over the first 12 weeks, with partial decreases over the dose-reduction period.

This study was very small, and little detailed information was provided. The findings are not very different from other studies of rhGH in patients with lipodystrophy, however. It is somewhat encouraging that patients with peripheral fat loss do not seem to have significant problems with further fat loss while on rhGH treatment and a maintenance dose, and patients were happy with the visual improvements overall while on treatment. However, rhGH does not seem to greatly improve limb fat loss. So, for people with loss of lean body mass, rhGH is one way to increase muscle mass and weight, but it does not seem to be a significant benefit for peripheral fat loss itself.