The Use of Nutropin Depot in HIV-infected Adult Males

Study Overview
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Brief Summary
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This is a pilot study. We will treat 10 HIV-infected adults (1/2 with lipoatrophy) with GH depot for one year. Results will be compared to data from 10 HIV patients (1/2 with lipoatrophy), treated with Nutropin AQ subcutaneously. The primary endpoint of the study is to determine the effect of GH depot on body weight and lean tissue mass (LTM). The secondary endpoints are to document changes in: 1) whole body protein turnover (WBPT), 2) gluconeogenesis, 3) bone mineral density and markers of bone turnover, 4) fat distribution (lipoatrophy), 5) thymus size, 6) T-cell subsets, and 7) TNF-µ levels. Adverse events, such as glucose intolerance and edema, will be monitored at every visit.

Detailed Description
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Patients will be recruited from the HIV clinics at University of Texas Southwestern Medical School and the Veterans Administration Hospital by direct invitation from Dr. Margolis (adult HIV clinic director and University director for the NIH-ACTG). We will recruit 20 HIV-infected adult males who have been treated with stable protease inhibitor therapy regimen for the past 6 months. One half of the subjects will have evidence of lipoatrophy (as defined by the ACTG29). Each subject will have baseline (BL) measures made, and then will start on GH depot or subcutaneous AQ. Patients will be followed every two weeks for the first six weeks, then every three months for the remainder of the study. Study parameters to be measured include (also see flow chart in appendix): Baseline, 3, 6 and 12 months: OGTT, testosterone level, whole body protein turnover, hepatic glucose production and gluconeogenesis measures, DXA scan (for measuring lean tissue mass and bone density), bone mineral markers, resting energy expenditure, calorie count, T cell subsets, TNF µ levels. Every 3 months: IGF-1 (will obtain every 2 weeks for first 6 weeks), body weight, and post-prandial glucose level. Baseline, 6 and 12 months- CT scan for measurement of thymus size

Conditions
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HIV Infection

Intervention / Treatment
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* Drug: Nutropin
* Procedure: Oral Glucose Tolerance Test
* Procedure: Dual Energy X-ray Absorptiometry (DEXA)
* Procedure: Computed Tomography (CT) Scan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult males ≥ 18 years of age mild to moderate lipoatrophy stable protease inhibitor therapy for at least six months. Exclusion Criteria: Con-current supra-infection with acute illness defined by fever or bacterial culture malignancy females diabetes mellitus CNS tumors.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Nutropin|nan|
|Procedure: Oral Glucose Tolerance Test|nan|
|Procedure: Dual Energy X-ray Absorptiometry (DEXA)|nan|
|Procedure: Computed Tomography (CT) Scan|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1) body weight |  |  | 
| 2) lean tissue mass (LTM). |  |  | 
| Testosterone levels |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1) whole body protein turnover (WBPT) |  |  | 
| 2) gluconeogenesis |  |  | 
| 3) bone mineral density and markers of bone turnover |  |  | 
| 4) fat distribution (lipoatrophy) |  |  | 
| 5) thymus size |  |  | 
| 6) T-cell subsets |  |  | 
| 7) TNF-µ level |  |  |