Fifth International Congress Drug Therapy in HIV Infection 22-26 October, 2000 Glasgow, UK

THE USE OF RECOMBINANT GROWTH HORMONE IN PATIENTS WITH ABDOMINAL FAT ACCUMULATION

M Gorensek¹ and T. Strawbridge^2
1 Cleveland Clinic, Fort Lauderdale, Florida, USA; ² Serono, Inc., Norwell, Massachusetts, USA

Int Cong Drug Therapy HIV 2000 Oct 22-26;5:Abstract No. P148
AIDS 2000, Oct 22-26;14(Suppl. 4); S59

BACKGROUND: HIV-associated redistribution (HARS) is a syndrome which is manifestations of peripheral lipoatrophy, central fat accumulation, enlargement of dorsocervical fat pads (buffalo hump), breast enlargement (mostly in women), and multiple or solitary lipomas. Speculation as to what causes HARS continues to be controversial worldwide. There are wide variations in the reported incidence of HARS (5–60%) mostly due to the lack of an agreed case definition.

OBJECTIVE: To determine whether or not recombinant human growth hormone (r-hGH[m]) is effective in the reversal of abdominal fat accumulation in patients diagnosed with HARS.

SUBJECT: Case report of male patient diagnosed with AIDS wasting syndrome and HARS. Patient age 49 years old diagnosed HIV+ in 1988. Single nucleoside therapy was initiated in 1988. The patient tried various antiretroviral therapies and several protease inhibitors. In 1/98 the patient was prescribed epivir, zerit, and crixivan. however, the patient started to have significant 'bloating' of the abdomen and the crixivan was switched to fortovase. A stable regime of zerit, epivir, and fortovase was obtained in 6/98. Laboratory values indicate HIV-1 RNA PCR less than 134 copies/ml and CD4 count 641 mm³/38% at that time. However, the patient continued to complain of abdominal bloating (abdominal girth measurement 46.1/2 inches) and fatigue, in 10/98 r-hGH 6 mg/sq/qd was prescribed for AIDS wasting.

RESULTS: After 1 month of r-hGH[m] patients abdominal girth decreased from 46.1/2 inches to 38.5 inches. Patient stated his energy level increased and weight gain of 7.1/2 lbs was noted. After 3 months of continuous therapy with r-hGH[m] the patient's abdominal girth measured 38.5 inches. There were no consistent changes in blood lipids, glucose, CD4 counts, and viral loads.

CONCLUSION: r-hGH[m] is effective in the treatment of AIDS wasting and has shown effectiveness in reducing abdominal fat accumulation. The durability of r-hGH[m] in maintaining these effects is unknown. Further studies are needed to evaluate the long-term effects of r-hGH [m] in patients diagnosed with HARS.

Presenting author: M Gorensek

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2000-10-22
P148

Originally published in AIDS Volume 14, Supplement 4 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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