Researchers from the Dartmouth Institute for Health Policy and Clinical Practice have found that growth hormone axis drugs are effective in treating HIV-associated lipodystrophy, as published in an article in the journal HIV Medicine on January 25.
Some HIV patients suffer from an associated disorder of fat metabolism called HIV-associated lipodystrophy. According to the researchers, HIV-associated lipodystrophy can decrease self-perception of body image, cause changes in fat metabolism, and decrease effectiveness of highly active antiretroviral therapy (HAART).
T. Sivakumar and the three other researchers explain HAART as a group of “potent antiretroviral agents, which have dramatically improved clinical outcomes in patients with HIV.” However, HAART also increases a patient’s chances of incurring HIV-associated lipodystrophy. Sivakumar et al. claim that 13-40% of HIV patients on HAART have HIV-associated lipodystrophy whereas only 4% of HIV patients not on HAART have the disorder.
Since clinical trials have demonstrated HAART’s effectiveness in treating HIV infections, the researchers argue that finding new methods to effectively treat HIV-associated lipodystrophy is important. Although many types of drugs have been explored, Sivakumar et al. claim that growth hormone axis drugs are especially promising.
The research team believes that one of the reasons growth hormone drugs are effective in treating HIV-associated lipodystrophy is that they cause the body to metabolize more fat instead of carbohydrates. In doing so, growth hormone axis treatments reduce fat tissue and increase lean body mass in patients with HIV-associated lipodystrophy.
Although there have been clinical trials of the treatment of HIV-associated lipodystrophy with growth hormone axis drugs, Sivakumar et al. claim “no systematic review has been conducted previously.” Therefore, they compiled data from various clinical trials to compare the effects of growth hormone axis drugs and the placebo in changing fat body tissue and lean body mass in HIV-associated lipodystrophy patients.
Sivakumar and the researcher team found 10 relevant studies by searching online databases. The researchers analyzed the data from the 10 studies and found that growth hormone axis drugs reduce fat tissue and cause a “significant change in LBM [lean body mass] compared with placebo.”
Although HAART treatments are effective against HIV, many patients undergoing HAART treatments suffer “metabolic derangements, including central fat accumulation and peripheral lipodystrophy.” According to Sivakumar et al., this HIV-associated lipodystrophy can lower self-esteem and even provide a visual sign of HIV. Even though the researchers claim there is not enough evidence to recommend regular use of growth hormone axis drugs, they suggest that clinicians consider growth hormone axis drugs with certain patients.
They also suggest that more research is done into the relationship of HIV-associated lipodystrophy and growth hormone axis drugs. Sivakumar et al. claim that long-term studies should determine long-term benefits, effects after discontinuation, and potential adverse side effects of growth hormone axis drugs in the treatment of HIV-associated lipodystrophy.