In HIV disease, human growth hormone is best known as a treatment for HIV-related wasting, although it is not an approved treatment for this condition in Europe. High doses of human growth hormone have been found to increase weight and lean body mass in people with AIDS wasting (Moyle; Schmitt-Rau; Schambelan; Paton). An increase in lean body mass is thought to be important in HIV disease because the loss of lean body mass is the form of wasting most closely related to an increased risk of death. For more information see A to Z of illnesses: Wasting syndrome.

In August 1996 human growth hormone was granted accelerated approval in the USA for the treatment of AIDS wasting. Studies of up to 12 weeks in duration have found that the drug may stabilize weight or reverse weight loss in people with HIV, although no improvements in survival were seen. The long-term safety and tolerability of human growth hormone are unknown.

In the European Union human growth hormone has been granted Orphan Drug status for the treatment of AIDS wasting, which means that Serono will have exclusive rights to market the product for this purpose in Europe, even though other companies also have their own versions of human growth hormone. The measure is designed to encourage companies to develop drugs in areas where the number of patients likely to benefit is very low.

Two large, randomized trials presented at the 2002 International AIDS Conference in Barcelona confirmed that human growth hormone can reduce abdominal fat and increase muscle in people taking anti-HIV therapies, confirming previous reports (Kotler; Moyle). Reductions in ‘buffalo hump’ and breast size have also been reported, although breast development in men has been noted as a side-effect of rHGH. However, improvements may reverse on stopping rHGH and may be more likely among individuals with mild body fat abnormalities.

The benefits of rHGH seem to be limited to boosting muscles and decreasing fat accumulation. It has no effect on fat loss in the face and limbs, and does not impact on ‘thinning’ bones.