Effectiveness of subcutaneous growth hormone in HIV-1 patients with moderate to severe facial lipoatrophy.
OBJECTIVE
To evaluate effect of recombinant human growth hormone (rhGH) among HIV-infected adults with moderate to severe facial lipoatrophy as a side effect of long-term antiretroviral treatment.


METHODS
A prospective open-label study


METHODS
Twenty-five HIV-1 patients with moderate to severe facial lipoatrophy who had been on antiretroviral treatment for more than 18 months were enrolled. rhGH (5 mg) was given every other day for 6 months. After treatment was completed, the participants were followed up for 6 months. Facial lipoatrophy was evaluated by computed tomography at months 0, 3, 6 and 12.


RESULTS
Nearly all participants (24 of 25) completed the study. The sum of bilateral soft tissue thickness at the level of zygomatics at months 0, 3, 6, 12 were 7.23, 8.59, 8.35, 8.60 mm, respectively. There was significant improvement from baseline in month 3 (p=0.009) and month 12 (p=0.021). In the 6 months of follow-up, the soft tissue showed no significant decrease. Several side effects including diarrhea, arthralgia, myalgia, mastalgia and hand numbness were seen, which were self-limited and transient.


CONCLUSIONS
rhGH is effective and relatively safe for moderate to severe facial lipoatrophy. Its effect was sustained at least for 6 months after the cessation of rhGH.
Honda
Miwako
M
AIDS Clinical Center, International Medical Center of Japan, Tokyo, Japan. mihonda@imcj.acc.go.jp <mihonda@imcj.acc.go.jp>
Yogi
Akira
A
Ishizuka
Naoki
N
Genka
Ikumi
I
Gatanaga
Hiroyuki
H
Teruya
Katsuji
K
Tachikawa
Natsuo
N
Kikuchi
Yoshimi
Y
Oka
Shinichi
S
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D013006:Growth Hormone / Q000008:administration & dosage*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
D013006:Growth Hormone