July 16, 2004

ADVANCES
Growth hormone control may affect HIV lipodystrophy treatment

I ncreasing the body's production of growth hormone may be an effective treatment for HIV lipodystrophy, a syndrome involving the redistribution of fat and other metabolic changes in those receiving combination drug therapy for AIDS. MGH researchers reported in the July 14 Journal of the American Medical Association that administration of growth-hormone-releasing hormone (GHRH) significantly improved fat distribution with no negative side effects in men with HIV lipodystrophy.

"This study is an initial proof of principal that this way of augmenting low growth hormone levels has the potential to reverse the abnormal body composition seen in these individuals," says Steven Grinspoon, MD (right), director of the MGH Neuroendocrine Unit and Program in Nutritional Metabolism, the report's senior author.

More than half of HIV-infected individuals treated with combination therapy may develop lipodystrophy. It also has been recently discovered that men with lipodystrophy do not secrete normal levels of growth hormone. But although growth-hormone injections can reduce fat deposits, they also have significant side effects that can make some lipodystrophy symptoms worse.

To achieve more natural control of growth hormone levels, the MGH team devised a strategy using growth-hormone-releasing hormone. At the end of the 12-week study, participants who received twice-daily injections of GHRH had more normal fat distribution than did those receiving placebo injections, without significant side effects. Measurements of a key blood factor involved in growth hormone secretion indicated that hormone production and regulation were improved.

"The novel part of this study was use of a natural secretion inducer to produce normal hormone levels," says Grinspoon. MGH co-authors include first author Polyxeni Koutkia, MD, Bridget Canavan, Martin Torriani, MD, and John Kissko.