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Beefing Up AIDS Patients

Daily injections of human growth hormone (HGH) appear to counteract the devastating and sometimes deadly effects of weight loss and atrophy often seen in AIDS patients, according to a study published in the latest issue of the Annals of Internal Medicine. But other reports in the same issue suggest that the therapy's effectiveness is far from proven.

In a multicenter trial led by Morris Schambelan of the University of California, San Francisco (UCSF), 90 AIDS patients placed on a daily HGH regimen gained back on average 3 kilograms of muscle, while those given a placebo did not gain back any. The hormone strengthened the patients, who performed better on treadmill tests after the 3-month trial. For AIDS patients on appetite stimulants, commonly prescribed by physicians, fat accounts for much of the weight gain. "What this therapy has done is show that there is a clear-cut possibility of ameliorating the lean-tissue depletion," Schambelan says.

But a second study in the same issue suggests that large doses may be required to achieve clear-cut benefits. Researchers at the University of New Mexico School of Medicine gave 15 AIDS patients smaller doses of HGH and saw only slight weight increases. The authors concluded that they could not recommend "sustained therapy" with small amounts of the hormone.

Schambelan says the results are "not that different," pointing to the smaller number of patients in the New Mexico study and the fact that patients in the UCSF study received on average six times as much HGH. However, in an editorial in the same issue, Christos Mantzoros and Alan Moses of Boston's Beth Israel Deaconess Medical Center argue that the "jury is still out" on the costly HGH treatment. The studies, they conclude, only provide "strong impetus for additional research."