Low-dose growth hormone therapy reduces inflammation in HIV-infected patients

Low-dose growth hormone therapy reduces inflammation in HIV-infected patients

Randomized controlled trial

Lindboe JB, et al. Infect Dis (Lond). 2016 Nov-Dec.

Authors

Lindboe JB1, Langkilde A1, Eugen-Olsen J2, Hansen BR2,3, Haupt TH1, Petersen J1,4, Andersen O1,3.

Author information

  • 1a Optimed, Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark ;
  • 2b Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark ;
  • 3c Department of Infectious Diseases , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark ;
  • 4d Department of Biostatistics , University of Copenhagen , Copenhagen , Denmark.

Citation

Infect Dis (Lond). 2016 Nov-Dec;48(11-12):829-37. doi: 10.1080/23744235.2016.1201722. Epub 2016 Jul 15.

Abstract

BACKGROUND: Combination antiretroviral therapy (cART) has drastically increased the life expectancy of HIV-infected patients. However, HIV-infected patients exhibit increased inflammation and 33-58% exhibit a characteristic fat re-distribution termed HIV-associated lipodystrophy syndrome (HALS). Recombinant human growth hormone (rhGH) has been tested as treatment of HALS. Low-dose rhGH therapy improves thymopoiesis and fat distribution in HIV-infected patients and appears to be well tolerated. However, since high-dose rhGH is associated with adverse events related to inflammation, we wanted to investigate the impact of low-dose rhGH therapy on inflammation in HIV-infected patients.

METHODS: Forty-six cART-treated HIV-infected men were included in the HIV-GH low-dose (HIGH/Low) study: a randomized, placebo-controlled, double-blinded trial. Subjects were randomized 3:2 to 0.7 mg/day rhGH, or placebo for 40 weeks. rhGH was self-administered between 1 pm and 3 pm. The primary outcome of this substudy was changes in inflammation measured by plasma C-reactive protein (CRP) and soluble urokinase plasminogen activator receptor (suPAR).

RESULTS: Both CRP (-66%, p = 0.002) and suPAR (-9.7%, p = 0.06) decreased in the rhGH group compared to placebo; however, only CRP decreased significantly. The effect of rhGH on inflammation was not mediated through rhGH-induced changes in insulin-like growth factor 1, body composition, or immune parameters.

CONCLUSION: Daily 0.7 mg rhGH treatment for 40 weeks, administered at nadir endogenous GH secretion, significantly reduced CRP. The effect does not appear to be mediated by other factors. Our findings suggest that low-dose rhGH treatment may minimize long-term risks associated with high-dose rhGH therapy.

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