Efficacy of selected treatments of HIV wasting: a systematic review and meta-analysis.

Purpose: To assess the efficacy of recombinant human growth hormone (rhGH), testosterone, and anabolic steroids in the treatment of HIV wasting.

Methods: A systematic review and meta-analysis of studies published in English since 1996 was conducted. Studies of anabolic steroids, testosterone, and rhGH in treatment of HIV wasting reporting the efficacy outcomes of body composition measures, work output, or health-related quality of life (QoL) were eligible. Meta-analyses were performed for mean pre-post change in lean body mass (LBM), the within-study mean difference in pre-post change for LBM, and of odds ratios for certain safety events.

Results: A total of 18 studies met inclusion criteria for this review.

Conclusion: The 3 treatments for HIV wasting assessed--rhGH, testosterone, and anabolic steroids--all demonstrated significant efficacy in increasing LBM as compared with placebo. Although meta-analysis did not indicate any statistically significant differences between these agents in the degree of efficacy in this outcome, the Food and Drug Administration-approved dose of rhGH may have advantages over the other 2 therapies in terms of improvements in functional capacity and QoL.