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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #63844
Title: CHANGES IN BODY COMPOSITION OF HIV INFECTED MALES RECEIVING INSULIN LIKE GROWTH FACTOR-I AND GROWTH HORMONE

Author
item ELLIS, KENNETH - BAYLOR COLL OF MEDICINE
item LEE, PHILIP - BAYLOR COLL OF MEDICINE
item PIVARNIK, JAMES - BAYLOR COLL OF MEDICINE
item BUKAR, JULIE - BAYLOR COLL OF MEDICINE
item GESUNDHEIT, NEIL - BAYLOR COLL OF MEDICINE

Submitted to: Journal of Clinical Endocrinology and Metabolism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/27/1996
Publication Date: N/A
Citation: N/A

Interpretive Summary: Unintentional weight loss is a serious problem of the people who suffer from long-term infection of the human immunodeficiency virus (HIV). Chronic weight loss greater than 10 percent produces a diagnosis of AIDS, which is fatal. But only a few studies have looked at the body composition changes connected with this problem. We wanted to do such a study and figure out whether a certain dose of two ingredients growth hormone and insulin-like growth factor-I (IGF-I) would stop continued weight loss in HIV-positive men who already had lost at least 10 percent of their weight. Previous studies have indicated these ingredients seem to help stop weight loss. The measurements we got showed that the dose we used did not restore lean-tissue mass, although there was no progression of weight loss during the 12 weeks of the study. Our study is important because it adds to the body of information about potential therapy to deal with the HIV-AIDS epidemic in this country, and more work should ultimately figure out the exact dose that would stop this ongoing weight-loss problem.

Technical Abstract: Weight loss is a common, persistent characteristic of long-term HIV-1 infection; its full etiology remains unknown. Because treatment with growth hormone (GH) has induced nitrogen retention in various catabolic conditions, we designed this study to determine whether a moderate dose of insulin-like growth factor-I (IGF-I) combined with a low GH dose could impede the catabolic response seen in HIV-1 infection. A double-blind, placebo-controlled study design was used. Subjects in the GH/IGF-I treatment group (n = 44 ) and control group (n = 22 ) continued to receive their routine stable anti-retroviral therapy. No patient had a recent history of opportunistic infection, malignancy, or Kaposi's sarcoma and had dietary intakes of at least 25 kcal/kg weight per day at study entry. During the 12-week study period, dietary instruction was given and subjects were encourage to maintain an intake of 35 kcal/kg and 1 gm protein/kg. All subjects had a body mass index (BMI) < 19.8 kg/m2 at time of study entry or a weight loss > 10% of their pre-morbid weight and a BMI < 26.1 kg/m2. The treatment group received daily injections for a total dose of 0.34 mg GH and 10 mg IGF-I. Changes in body composition of total body potassium (TBK), total body nitrogen (TBN), fat-free mass (FFM), and body fat (Fat) were examined at 6 and 12 weeks during the treatment period. TBK, TBN, FFM, and Fat for the treatment and placebo groups were, on average, below normal at study entry. At 6 weeks, the GH/IGF-I group showed a significant increase in FFM (p<0.0001), minimal increase in TBK (p<0.05), and a substantial decrease in Fat (p<0.01) compared with baseline values. The loss of body fat continued to be significant ( p<0.01) in the GH/IGF-I group treatment at 12 weeks, whereas the increase in FFM was