Windisch P A, Papatheofanis F J, Matuszewski K A
Clinical Practice Advancement Center, University HealthSystem Consortium, Oak Brook, IL 60521, USA.
Ann Pharmacother. 1998 Apr;32(4):437-45. doi: 10.1345/aph.17255.
To review the current literature regarding the role of recombinant human growth hormone (rhGH) in the treatment of AIDS-associated wasting and to briefly describe alternative therapies.
A literature search was performed on MEDLINE and AIDSLINE for the period from January 1985 through September 1997. Key words used in the search strategy were growth hormone, human immunodeficiency virus, acquired immune deficiency syndrome, wasting, and weight gain.
All articles were considered for possible inclusion in this review. Abstracts were included only when they were judged to add critical information. Thereafter, the inclusion was restricted to English-language articles and abstracts on clinical trials and human studies in AIDS-associated wasting.
Body wasting, characterized by an involuntary loss of body cell mass, is a well-recognized feature of many chronic diseases, including infection with HIV AIDS-associated wasting is a metabolic disorder characterized by weight loss, depletion of lean body mass (LBM), and preservation of body fat, leading to muscle weakness and organ failure. rhGH has been approved by the Food and Drug Administration for use in treating AIDS-associated wasting. The adverse event profile is similar to that of other rhGH products. The recommended dosage of rhGH is 4-6 mg administered by subcutaneous injection daily. It offers a more expensive alternative to appetite stimulants such as megestrol acetate and dronabinol.
Trials with rhGH on the control of wasting in patients with AIDS have been encouraging, but with limited conclusive evidence of sustainable positive outcomes. Studies demonstrate that rhGH increases LBM and decrease adipose tissue, but how these translate into long-term outcomes such as decreased hospitalization, morbidity, and mortality has yet to be determined. A formal health economic assessment is needed to properly determine the impact of rhGH on the healthcare system.
综述有关重组人生长激素（rhGH）在治疗艾滋病相关消瘦中作用的当前文献，并简要描述替代疗法。
对1985年1月至1997年9月期间的MEDLINE和AIDSLINE进行了文献检索。检索策略中使用的关键词为生长激素、人类免疫缺陷病毒、获得性免疫缺陷综合征、消瘦和体重增加。
所有文章均被考虑可能纳入本综述。仅当摘要被判定能提供关键信息时才被纳入。此后，纳入范围限于关于艾滋病相关消瘦的临床试验和人体研究的英文文章及摘要。
身体消瘦以体细胞质量的非自愿丢失为特征，是包括感染HIV在内的许多慢性疾病的一个公认特征。艾滋病相关消瘦是一种代谢紊乱，其特征为体重减轻、瘦体重（LBM）减少以及体脂保留，导致肌肉无力和器官衰竭。rhGH已获美国食品药品监督管理局批准用于治疗艾滋病相关消瘦。不良事件谱与其他rhGH产品相似。rhGH的推荐剂量为每日4 - 6毫克皮下注射。它比醋酸甲地孕酮和屈大麻酚等食欲刺激剂提供了一种更昂贵的替代选择。
rhGH控制艾滋病患者消瘦的试验令人鼓舞，但可持续阳性结果的确凿证据有限。研究表明rhGH可增加LBM并减少脂肪组织，但这些如何转化为诸如减少住院、发病率和死亡率等长期结果尚未确定。需要进行正式的卫生经济评估以正确确定rhGH对医疗保健系统的影响。
