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Recombinant human growth hormone therapy for cachexia in HIV infected children.

Pinto G, Brauner R, Goulet O, Clapin A, Blanche S; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 4th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 4th 1997 Wash DC. 1997 Jan 22-26; 4th: 192 (abstract no. 690).

Hopital Necker-Enfants Malades, Paris, France.

BACKGROUND: Poor growth and decreased weight gain are prominent features of pediatric HIV infection. Mammalian Cell-derived Recombinant-human Growth Hormone (r-hGH[m]) has been shown to increase lean body mass and body weight and to improve physical performance and quality of life in adults with AIDS wasting. The aim of this preliminary study was to evaluate acceptability, tolerance and efficacy of daily subcutaneous injection of r-hGH[m] in 6 children with HIV-associated failure to thrive. STUDY DESIGN: Main inclusion criteria were HIV positivity, age over 6 and under 15 yrs, height velocity below -2 SD for chronological age, anti-retroviral therapy for more than 1 month, GH peak greater than or equal to 10 ng/ml. Children could receive enteral tube feeding which had to be introduced for at least one month and well tolerated. Children were treated for 28 days with r-hGH[m] 0.2 IU/kg/d (0.67 mg/kg/d). After the study period, each child was offered on-going therapy with r-hGH[m]. Outcome parameters included fat-free mass (determined by bioelectrical impedance analysis), weight, CD4 count, p24 Ag, HIV RNA and IGF-1. RESULTS: At time of analysis, 4 children (F/M: 3/1; ages: 8, 11, 14, 10 yrs) have completed the 28 day study. 3 were infected by mother-infant transmission. 2 were receiving enteral tube feeding. During the study period, mean fat-free mass and weight gain were + 1.40 and +0.83 kg, respectively; r-hGH[m] was well tolerated and no increase in viral load or p24 Ag occurred. At the end of the study period, all of the children wanted to continue r-hGH[m] treatment, giving evidence of good acceptability of the treatment. Data on 6 children, with results from the follow-up period on patients who continued (up to 7, including height velocity changes), will be presented.months CONCLUSION: These preliminary data of r-hGH[m] treatment for HIV infected children are consistent with those previously described in adults. All children accepted daily sub-cutaneous injections of r-hGH[m]. Due to entry criteria, only children with relatively advanced failure to thrive were included in this study. A comparative study is warranted, and should involve children at an earlier stage of disease.

Publication Types:
  • Meeting Abstracts
Keywords:
  • AIDS Vaccines
  • Acquired Immunodeficiency Syndrome
  • Adult
  • Antiretroviral Therapy, Highly Active
  • Body Composition
  • Body Height
  • Body Weight
  • CD4 Lymphocyte Count
  • Cachexia
  • Child
  • Electric Impedance
  • Failure to Thrive
  • Growth
  • Growth Disorders
  • Growth Hormone
  • HIV Infections
  • HIV Seropositivity
  • Human Growth Hormone
  • Humans
  • Infant
  • Insulin-Like Growth Factor I
  • Nutritional Status
  • Viral Load
  • Weight Gain
  • drug therapy
  • therapy
Other ID:
  • 97926665
UI: 102223674

From Meeting Abstracts




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