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Treatment of Abnormal Adipose Tissue Accumulation in Human Immunodeficiency Virus (HIV) Patients

Primary Purpose

HIV Infections, Lipodystrophy

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Placebo
Serostim® 4 mg
Serostim® 2 mg
Sponsored by
EMD Serono
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Growth hormone, Serostim®, Human Adipose Redistribution Syndrome, Human Immunodeficiency Virus lipodystrophy

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Have written laboratory documentation of an HIV infection by one of the following methods: Detectable viral load measured by polymerase chain reaction (PCR) amplification, branched chain DNA (bDNA) signal amplification or the presence of p24 antigen. Presence of HIV antibodies confirmed by either Western blot or immunofluorescence assay. Written laboratory documentation of an HIV infection must be obtained prior to randomization. In the absence of documented historical confirmation, an assay of HIV antibodies will be included in the Screening Laboratory Panel. Results will be confirmed with a Western Blot. Have evidence of excess abdominal adipose deposition when measured by the anthropometric methodology, using the following cut off values: Men: Waist circumference >88.2 cm AND waist: hip ratio >= 0.95. Women: Waist circumference >75.3 cm AND waist: hip ratio >= 0.9. Are taking antiretroviral medication(s) which is (are) approved or is (are) available under a Treatment IND. The regimen must have remained stable for 30 days prior to study entry. Subjects must also agree not to discontinue or to change their regimen for the duration of the study except as judged medically necessary. Have parameter values less than the following limits (using results from the central laboratory): AST, ALT, and amylase <= 3 times the upper limit of normal (Screening). Fasting triglycerides <= 1,000 mg/dL (Screening). Fasting glucose <110 mg/dL (Screening). Two-hour (120 minute) glucose <140 mg/dL (Screening). Weight >= 36 kg (79.3 lb) Be between 18 and 60 years of age (inclusive) unless local law dictates different limits. Sufficiently literate in English to be able to comprehend and complete the Quality of Life Questionnaire. Willing and able to comply with the protocol for the duration of the study. Have voluntarily provided written informed consent (with subject authorization under HIPAA), prior to performing any study-related procedure that is not part of normal medical care, and with the understanding that the subject may withdraw consent at any time without prejudice to future medical care. Female subjects must: Be post menopausal (>= 1 year) or surgically sterilized (i.e., have undergone tubal ligation or hysterectomy) or Use a contraceptive method for the duration of the study such as: Hormonal contraceptive Intra uterine device Diaphragm with spermicide, or condom with spermicide. And Must be neither pregnant nor breast feeding. Confirmation that female subjects of childbearing potential are not pregnant must be established by a negative beta-hCG serum pregnancy test during the 14-day screening period prior to Study Day 1. If the beta-hCG serum pregnancy test is performed more than 7 days prior to Study Day 1, a urine pregnancy test must be performed by the site laboratory on Study Day 1 to confirm a negative test result. Exclusion Criteria: Have an active AIDS-defining opportunistic complication (OC) as defined by the CDC or have had an untreated or suspected serious systemic infection, or have had a persistent fever >= 101°F (38.3°C) during the 30 days prior to study entry. Any active or past history of malignancy, except for localized cutaneous Kaposi's sarcoma (fewer than 10 lesions, none of which are larger than 2 cm, and not on active therapy). Such exceptions must be confirmed in writing by the Serono Study Director. Have a CNS mass or active CNS process associated with neurological findings. Have unstable or untreated hypertension, defined as >= 140/90 mm Hg at the time of the Screening Visit, and/or have initiated or changed antihypertensive therapy in the 30 days prior to Study Day 1. Have an acute critical illness treated in an intensive care unit, e.g., due to complications following open heart or abdominal surgery, multiple accidental trauma, or acute respiratory failure. Have a recent history of sleep apnea or intermittent upper respiratory obstruction. Have any condition, which interferes with informed consent or protocol compliance including, but not limited to, active substance abuse and/or dementia. Are unable to comply with the Concomitant Therapy restrictions including: therapy for obesity including therapy with anorexigenic or fat reducing drugs anti-diabetic or insulin sensitizing medications systemic glucocorticoids systemic chemotherapy, interferon or radiation therapy treatment androgenic agents including, but not limited to testosterone, nandrolone, oxandrolone, oxymetholone, etc. (testosterone replacement therapy for hypogonadism is the exception to this exclusion and will be allowed if started > 30 days prior to Study Day 1) progestational agents, unless used for oral contraception or post-menopausal hormone replacement therapy appetite stimulants investigational agents, unless approved in advance by the study medical director. Specifically, experimental antiretroviral agents are disallowed, unless available under a treatment IND or expanded access program (30 days). Liposuction or other elective plastic surgery AIDS wasting therapy or prior growth hormone treatment other than study drug (for 12 months prior to the screening visit) Have ever been diagnosed with any of the following conditions: Pancreatitis Carpal tunnel syndrome (unless resolved by surgical release) Diabetes mellitus Angina pectoris Coronary artery disease Any disorder associated with moderate to severe edema (e.g., ascites, nephrotic syndrome, congestive heart failure, lymphedema). Allergy or hypersensitivity to growth hormone. Are participating in any other clinical studies. In order to participate in this trial a subject must meet all of the inclusion and exclusion criteria specified above. Requests for protocol exceptions/exemptions must come from a participating, fully initiated site at which a prospective patient has consented to undergo screening. Exceptions/exemptions are only allowed by the Trial Director. There is no program in place to allow drug for a single patient IND, or for an expanded access protocol. This statement holds true for both children and adults.

Sites / Locations

  • University of Alabama/Birmingham
  • CARE CLINIC - UCLA Medical Center
  • 1401 N. Palm Canyon
  • Trials Unit Div of Infectious and Immunologic Diseases
  • UCSD - AntiViral Research Center
  • University of California, San Francisco - Div. of Endocrinology
  • Kaiser Permanente
  • Northern California Institute for Research and Education, Inc.
  • Harbor-UCLA Medical Ctr Research & Education Institute
  • AIDS Alliance
  • University of Colorado Health Sciences Center
  • 1640 Rhode Island Avenue, N.W.
  • Office Of Dr Gary Richmond
  • 3661 South Miami Avenue
  • Care Resources
  • Infectious Disease Associates
  • AIDS Research Consortium of Atlanta
  • Rush University Medical Center
  • Indiana University Infectious Disease Research Clinic
  • Tufts University School of Medicine
  • Community Research Initiative of New England
  • Community Research Initiative Of New England
  • Hennepin County Medical Center
  • Albany Medical College
  • Weill Medical College of Cornell Universtiy
  • St. Luke's Roosevelt Hospital
  • Bronx Women's Interagency HIV Study
  • Central Texas Clincial research
  • IDP Research
  • Office of Daniel Coulston, M.D.
  • AIDS Research Program

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Placebo Comparator

Experimental

Experimental

Experimental

Experimental

Arm Label

Period I: Placebo

Period I: Serostim® 4 mg

Period II: Serostim® 4 mg to Placebo

Period II: Serostim® 4 mg to Serostim® 2 mg

Period II: Placebo to Placebo/Serostim® 4 mg

Arm Description

Subjects will receive placebo matched to serostim® as subcutaneous injection daily for a period of 12 weeks.

Subjects will receive Serostim® as subcutaneous injection at a maximum dose of 4 milligram (mg) per day based on body weight for a period of 12 weeks.

All subjects who will be initially randomized to Serostim® 4 mg arm in Period I and will receive placebo matched to Serostim® on alternate days for 24 weeks in Period II.

All subjects who will be initially randomized to Serostim® 4 mg arm in Period I and will receive Serostim® 2 mg on alternate days for 24 weeks in Period II.

All subjects who will be initially randomized to Placebo arm in Period I continue receiving placebo matched to Serostim® on alternate days for 12 weeks followed by Serostim® 4 mg daily 12 weeks.

Outcomes

Primary Outcome Measures

Treatment Period I: Change From Baseline in Absolute Area of Visceral Adipose Tissue (VAT) at Week 12
Absolute area of VAT was measured by cross-sectional computed tomography (CT) scan at the level of the L4-5 inter-vertebral disk. CT scanning was to be used to assess the cross sectional area of abdominal fat and its distribution between the visceral and subcutaneous compartments, as measured at L4-L5.

Secondary Outcome Measures

Treatment Period I: Change From Baseline in Trunk Fat at Week 12
Changes in trunk fat was measured as changes in mass (kg) on Dual-Energy X-Ray Absorptiometry (DXA) Scan.
Change From Baseline in Patient Reported Outcome of Body Image Distress at Week 12
Body image distress was assessed on a scale ranging from 0 to 100, where 0 = Extremely Upsetting and 100 = Extremely Encouraging.
Treatment Period I: Change From Baseline in Non- High-density Lipoprotein (Non-HDL) Cholesterol at Week 12
Lipid profile data was analyzed for Non-HDL Cholesterol.
Treatment Period II: Failure Rate at Week 36 Based on Visceral Adipose Tissue (VAT) For Subjects Who Received Serostim® 4 mg in Period I
Failure rate based on VAT was assessed by CT scan at L4-L5. The failure rate was defined as the percentage of subjects who regained >50% of their VAT lost in Treatment Period I. This outcome was to be assessed for subjects who received Serostim® 4 mg in Period I.

Full Information

First Posted
May 13, 2004
Last Updated
October 2, 2017
Sponsor
EMD Serono
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1. Study Identification

Unique Protocol Identification Number
NCT00082628
Brief Title
Treatment of Abnormal Adipose Tissue Accumulation in Human Immunodeficiency Virus (HIV) Patients
Official Title
A Phase III, Multi-Center, Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study of the Safety and Efficacy of Serostim®, r-hGH in the Treatment and Maintenance of Human Immunodeficiency HIV-Associated Adipose Redistribution Syndrome, or HARS
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
May 28, 2004 (Actual)
Primary Completion Date
September 28, 2005 (Actual)
Study Completion Date
September 28, 2005 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
EMD Serono

4. Oversight

5. Study Description

Brief Summary
The primary objective of the study is to determine if Serostim® 4 mg administered daily for 12 weeks as treatment for the abnormal fat accumulation and distribution associated with HIV-associated Adipose Redistribution Syndrome (HARS) reduces Visceral Adipose Tissue (VAT, measured by CT scan) more effectively than placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections, Lipodystrophy
Keywords
Growth hormone, Serostim®, Human Adipose Redistribution Syndrome, Human Immunodeficiency Virus lipodystrophy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
326 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Period I: Placebo
Arm Type
Placebo Comparator
Arm Description
Subjects will receive placebo matched to serostim® as subcutaneous injection daily for a period of 12 weeks.
Arm Title
Period I: Serostim® 4 mg
Arm Type
Experimental
Arm Description
Subjects will receive Serostim® as subcutaneous injection at a maximum dose of 4 milligram (mg) per day based on body weight for a period of 12 weeks.
Arm Title
Period II: Serostim® 4 mg to Placebo
Arm Type
Experimental
Arm Description
All subjects who will be initially randomized to Serostim® 4 mg arm in Period I and will receive placebo matched to Serostim® on alternate days for 24 weeks in Period II.
Arm Title
Period II: Serostim® 4 mg to Serostim® 2 mg
Arm Type
Experimental
Arm Description
All subjects who will be initially randomized to Serostim® 4 mg arm in Period I and will receive Serostim® 2 mg on alternate days for 24 weeks in Period II.
Arm Title
Period II: Placebo to Placebo/Serostim® 4 mg
Arm Type
Experimental
Arm Description
All subjects who will be initially randomized to Placebo arm in Period I continue receiving placebo matched to Serostim® on alternate days for 12 weeks followed by Serostim® 4 mg daily 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo matched to serostim® as subcutaneous injection.
Intervention Type
Drug
Intervention Name(s)
Serostim® 4 mg
Other Intervention Name(s)
recombinant human growth hormone (r-hGH)
Intervention Description
Serostim® as subcutaneous injection at a maximum dose of 4 milligram (mg) per day based on body weight.
Intervention Type
Drug
Intervention Name(s)
Serostim® 2 mg
Other Intervention Name(s)
recombinant human growth hormone (r-hGH)
Intervention Description
Serostim® 2 mg as subcutaneous injection on alternate days.
Primary Outcome Measure Information:
Title
Treatment Period I: Change From Baseline in Absolute Area of Visceral Adipose Tissue (VAT) at Week 12
Description
Absolute area of VAT was measured by cross-sectional computed tomography (CT) scan at the level of the L4-5 inter-vertebral disk. CT scanning was to be used to assess the cross sectional area of abdominal fat and its distribution between the visceral and subcutaneous compartments, as measured at L4-L5.
Time Frame
Baseline, Week 12
Secondary Outcome Measure Information:
Title
Treatment Period I: Change From Baseline in Trunk Fat at Week 12
Description
Changes in trunk fat was measured as changes in mass (kg) on Dual-Energy X-Ray Absorptiometry (DXA) Scan.
Time Frame
Baseline, Week 12
Title
Change From Baseline in Patient Reported Outcome of Body Image Distress at Week 12
Description
Body image distress was assessed on a scale ranging from 0 to 100, where 0 = Extremely Upsetting and 100 = Extremely Encouraging.
Time Frame
Baseline, Week 12
Title
Treatment Period I: Change From Baseline in Non- High-density Lipoprotein (Non-HDL) Cholesterol at Week 12
Description
Lipid profile data was analyzed for Non-HDL Cholesterol.
Time Frame
Baseline, Week 12
Title
Treatment Period II: Failure Rate at Week 36 Based on Visceral Adipose Tissue (VAT) For Subjects Who Received Serostim® 4 mg in Period I
Description
Failure rate based on VAT was assessed by CT scan at L4-L5. The failure rate was defined as the percentage of subjects who regained >50% of their VAT lost in Treatment Period I. This outcome was to be assessed for subjects who received Serostim® 4 mg in Period I.
Time Frame
Week 36

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have written laboratory documentation of an HIV infection by one of the following methods: Detectable viral load measured by polymerase chain reaction (PCR) amplification, branched chain DNA (bDNA) signal amplification or the presence of p24 antigen. Presence of HIV antibodies confirmed by either Western blot or immunofluorescence assay. Written laboratory documentation of an HIV infection must be obtained prior to randomization. In the absence of documented historical confirmation, an assay of HIV antibodies will be included in the Screening Laboratory Panel. Results will be confirmed with a Western Blot. Have evidence of excess abdominal adipose deposition when measured by the anthropometric methodology, using the following cut off values: Men: Waist circumference >88.2 cm AND waist: hip ratio >= 0.95. Women: Waist circumference >75.3 cm AND waist: hip ratio >= 0.9. Are taking antiretroviral medication(s) which is (are) approved or is (are) available under a Treatment IND. The regimen must have remained stable for 30 days prior to study entry. Subjects must also agree not to discontinue or to change their regimen for the duration of the study except as judged medically necessary. Have parameter values less than the following limits (using results from the central laboratory): AST, ALT, and amylase <= 3 times the upper limit of normal (Screening). Fasting triglycerides <= 1,000 mg/dL (Screening). Fasting glucose <110 mg/dL (Screening). Two-hour (120 minute) glucose <140 mg/dL (Screening). Weight >= 36 kg (79.3 lb) Be between 18 and 60 years of age (inclusive) unless local law dictates different limits. Sufficiently literate in English to be able to comprehend and complete the Quality of Life Questionnaire. Willing and able to comply with the protocol for the duration of the study. Have voluntarily provided written informed consent (with subject authorization under HIPAA), prior to performing any study-related procedure that is not part of normal medical care, and with the understanding that the subject may withdraw consent at any time without prejudice to future medical care. Female subjects must: Be post menopausal (>= 1 year) or surgically sterilized (i.e., have undergone tubal ligation or hysterectomy) or Use a contraceptive method for the duration of the study such as: Hormonal contraceptive Intra uterine device Diaphragm with spermicide, or condom with spermicide. And Must be neither pregnant nor breast feeding. Confirmation that female subjects of childbearing potential are not pregnant must be established by a negative beta-hCG serum pregnancy test during the 14-day screening period prior to Study Day 1. If the beta-hCG serum pregnancy test is performed more than 7 days prior to Study Day 1, a urine pregnancy test must be performed by the site laboratory on Study Day 1 to confirm a negative test result. Exclusion Criteria: Have an active AIDS-defining opportunistic complication (OC) as defined by the CDC or have had an untreated or suspected serious systemic infection, or have had a persistent fever >= 101°F (38.3°C) during the 30 days prior to study entry. Any active or past history of malignancy, except for localized cutaneous Kaposi's sarcoma (fewer than 10 lesions, none of which are larger than 2 cm, and not on active therapy). Such exceptions must be confirmed in writing by the Serono Study Director. Have a CNS mass or active CNS process associated with neurological findings. Have unstable or untreated hypertension, defined as >= 140/90 mm Hg at the time of the Screening Visit, and/or have initiated or changed antihypertensive therapy in the 30 days prior to Study Day 1. Have an acute critical illness treated in an intensive care unit, e.g., due to complications following open heart or abdominal surgery, multiple accidental trauma, or acute respiratory failure. Have a recent history of sleep apnea or intermittent upper respiratory obstruction. Have any condition, which interferes with informed consent or protocol compliance including, but not limited to, active substance abuse and/or dementia. Are unable to comply with the Concomitant Therapy restrictions including: therapy for obesity including therapy with anorexigenic or fat reducing drugs anti-diabetic or insulin sensitizing medications systemic glucocorticoids systemic chemotherapy, interferon or radiation therapy treatment androgenic agents including, but not limited to testosterone, nandrolone, oxandrolone, oxymetholone, etc. (testosterone replacement therapy for hypogonadism is the exception to this exclusion and will be allowed if started > 30 days prior to Study Day 1) progestational agents, unless used for oral contraception or post-menopausal hormone replacement therapy appetite stimulants investigational agents, unless approved in advance by the study medical director. Specifically, experimental antiretroviral agents are disallowed, unless available under a treatment IND or expanded access program (30 days). Liposuction or other elective plastic surgery AIDS wasting therapy or prior growth hormone treatment other than study drug (for 12 months prior to the screening visit) Have ever been diagnosed with any of the following conditions: Pancreatitis Carpal tunnel syndrome (unless resolved by surgical release) Diabetes mellitus Angina pectoris Coronary artery disease Any disorder associated with moderate to severe edema (e.g., ascites, nephrotic syndrome, congestive heart failure, lymphedema). Allergy or hypersensitivity to growth hormone. Are participating in any other clinical studies. In order to participate in this trial a subject must meet all of the inclusion and exclusion criteria specified above. Requests for protocol exceptions/exemptions must come from a participating, fully initiated site at which a prospective patient has consented to undergo screening. Exceptions/exemptions are only allowed by the Trial Director. There is no program in place to allow drug for a single patient IND, or for an expanded access protocol. This statement holds true for both children and adults.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Responsible
Organizational Affiliation
EMD Serono Inc., a business of Merck KGaA, Darmstadt, Germany
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama/Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
CARE CLINIC - UCLA Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
1401 N. Palm Canyon
City
Palm Springs
State/Province
California
ZIP/Postal Code
92262
Country
United States
Facility Name
Trials Unit Div of Infectious and Immunologic Diseases
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
UCSD - AntiViral Research Center
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
University of California, San Francisco - Div. of Endocrinology
City
San Francisco
State/Province
California
ZIP/Postal Code
94110
Country
United States
Facility Name
Kaiser Permanente
City
San Francisco
State/Province
California
ZIP/Postal Code
94118
Country
United States
Facility Name
Northern California Institute for Research and Education, Inc.
City
San Francisco
State/Province
California
ZIP/Postal Code
94121
Country
United States
Facility Name
Harbor-UCLA Medical Ctr Research & Education Institute
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
AIDS Alliance
City
West Hollywood
State/Province
California
ZIP/Postal Code
90069
Country
United States
Facility Name
University of Colorado Health Sciences Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80262
Country
United States
Facility Name
1640 Rhode Island Avenue, N.W.
City
Washington, D.C.
State/Province
District of Columbia
ZIP/Postal Code
20036
Country
United States
Facility Name
Office Of Dr Gary Richmond
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33316
Country
United States
Facility Name
3661 South Miami Avenue
City
Miami
State/Province
Florida
ZIP/Postal Code
33133
Country
United States
Facility Name
Care Resources
City
Miami
State/Province
Florida
ZIP/Postal Code
33137
Country
United States
Facility Name
Infectious Disease Associates
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34239
Country
United States
Facility Name
AIDS Research Consortium of Atlanta
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Indiana University Infectious Disease Research Clinic
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Tufts University School of Medicine
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Community Research Initiative of New England
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Community Research Initiative Of New England
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01107
Country
United States
Facility Name
Hennepin County Medical Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55415
Country
United States
Facility Name
Albany Medical College
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
Weill Medical College of Cornell Universtiy
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
St. Luke's Roosevelt Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10025
Country
United States
Facility Name
Bronx Women's Interagency HIV Study
City
The Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
Central Texas Clincial research
City
Austin
State/Province
Texas
ZIP/Postal Code
78705
Country
United States
Facility Name
IDP Research
City
Annandale
State/Province
Virginia
ZIP/Postal Code
22003
Country
United States
Facility Name
Office of Daniel Coulston, M.D.
City
Spokane
State/Province
Washington
ZIP/Postal Code
99204
Country
United States
Facility Name
AIDS Research Program
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 1Y6
Country
Canada

12. IPD Sharing Statement

Links:
URL
http://www.serostim.com
Description
Full FDA approved prescribing information can be found here
URL
http://www.ncbi.nlm.nih.gov/pubmed/17592343?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1
Description
Link to PubMed
URL
http://journals.lww.com/jaids/Fulltext/2007/07010/Recombinant_Human_Growth_Hormone_to_Treat.6.aspx
Description
Related Info

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Treatment of Abnormal Adipose Tissue Accumulation in Human Immunodeficiency Virus (HIV) Patients

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