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Use of Growth Hormone and Other Anabolic Agents in AIDS Wasting
Author(s) -
Mulligan Kathleen,
Tai Viva W.,
Schambelan Morris
Publication year - 1999
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/014860719902300606
Subject(s) - oxandrolone , wasting , lean body mass , cachexia , medicine , anabolism , placebo , endocrinology , sarcopenia , weight loss , wasting syndrome , anabolic agents , hormone , growth hormone , obesity , body weight , alternative medicine , pathology , cancer
Body wasting and loss of lean body mass (LBM) have been associated with increased mortality and disease progression, and reduced quality of life, in patients with human immunodeficiency virus (HIV) infection. The failure of nutritional therapies and, more recently, of effective viral suppression, to consistently restore LBM has prompted investigation of the pharmacologic use of a number of specific protein anabolic agents, including recombinant human growth hormone (rhGH), insulinlike growth factor I (rhIGF‐I), and synthetic testosterone derivatives, such as nandrolone decanoate, oxandrolone, and oxymetholone. In a placebo‐controlled trial, treatment with rhGH resulted in a significant and sustained increase in weight that was accompanied by an even greater increase in LBM and a decrease in fat, and improvement in treadmill work output. Preliminary data suggest that short‐term rhGH treatment may be effective in mitigating weight loss in patients with secondary infections. Open‐label studies of nandrolone decanoate suggest that this injectable agent also can increase weight and LBM. Two oral agents, oxandrolone and oxymetholone, can increase weight, but their effects on LBM in placebo‐controlled trials have not been reported. Taken together, these studies demonstrate that HIV‐infected individuals can regain weight and LBM under the proper therapeutic circumstances. The effects of reversal of wasting on survival and disease progression, long‐term safety, and the potential value of these therapies in the treatment of fat redistribution remain to be determined. (Journal of Parenteral and Enteral Nutrition23:S202‐S209, 1999)