title: Sustained low-dose growth hormone therapy optimizes bioactive insulin-like growth factor-I level and may enhance CD4 T-cell number in HIV infection.
abstract: High-dose recombinant human growth hormone (rhGH) (2-6 mg/day) regimes may facilitate T-cell restoration in patients infected with human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART). However, high-dose rhGH regimens increase insulin-like growth factor-I (IGF-I) to supra-physiological levels associated with severe side effects. The present study investigated whether lower doses of rhGH may improve T-cell restoration in patients infected with HIV following an expedient response of total and bioactive (i.e., free) IGF-I. A previous 16-week pilot-study included six HIV-infected patients on stable HAART to receive rhGH 0.7 mg/day, which increased total (+117%, P < 0.01) and free (+155%, P < 0.01) IGF-I levels. The study was extended to examine whether continuous use of low-dose rhGH (0.7 mg/day until week 60; 0.4 mg/day from week 60 to week 140) would maintain expedient IGF-I levels and improve CD4 T-cell response. Total and free IGF-I increased at week 36 (+97%, P < 0.01 and +125%, P < 0.01, respectively) and week 60 (+77%, P = 0.01 and +125%, P < 0.01) compared to baseline levels (161 +/- 15 and 0.75 +/- 0.11 microg/L). CD4 T-cell number increased at week 36 (+15%, P < 0.05) and week 60 (+31%, P = 0.01) compared to baseline levels (456 +/- 55 cells/microL). Following rhGH dose reduction, total IGF-I and CD4 T-cell number remained increased at week 88 (+44%, P = 0.01 and +33%, P < 0.01) and week 140 (+46%, P = 0.07 and +36%, P = 0.02) compared to baseline levels. These data support the notion that low-dose rhGH regimens may increase expediently total and bioactive IGF-I and improve T-cell restoration in patients infected with HIV on HAART.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Hvidovre, Copenhagen, Denmark. ove.andersen.privat@gmail.com
authors.forename: Ove
authors.initials: O
authors.lastname: Andersen
authors.forename: Birgitte Rønde
authors.initials: BR
authors.lastname: Hansen
authors.forename: William
authors.initials: W
authors.lastname: Troensegaard
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.forename: Sten
authors.initials: S
authors.lastname: Madsbad
authors.forename: Hans
authors.initials: H
authors.lastname: Ørskov
authors.forename: Jens Ole
authors.initials: JO
authors.lastname: Nielsen
authors.forename: Johan
authors.initials: J
authors.lastname: Iversen
authors.forename: Steen B
authors.initials: SB
authors.lastname: Haugaard
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I