Effects of IGF-I in HIV Metabolic Disease

Inclusion Criteria: * HIV positive with undetectable viral load * No change in antiretrovirals for 3 months * Evidence of lipoatrophy in the limbs, and face or gluteal area * Dyslipidemia defined as: * Fasting triglycerides \> 200 OR * HDL cholesterol \< 40 mg/dL * Abnormal glucose homeostasis defined as: * Fasting hyperinsulinemia \> 20 uU/mL OR * Fasting glucose 100-125 mg/dL, inclusive Exclusion Criteria: * Two consecutive viral \>75 or \> 50 copies/mL using the tests listed above * Presence of AIDS wasting * Change in antiretroviral medication (not dose) in the prior 3 months * Coronary artery disease, cerebrovascular, or peripheral arterial disease * Diabetes mellitus * Adrenal insufficiency, hypoglycemia, thyroid disease, or other endocrine disorder that is untreated * Malignancy * Eating disorder * Pregnancy (urine pregnancy test is required of all females) * Previous liposuction or bariatric surgery * Other systemic conditions or other disorders at the discretion of the investigators * Current use of systemic glucocorticoids, or other agent affecting body weight or glucose homeostasis or other drug at the discretion of the investigators * Use of interferon within the past six months * Use of insulin, insulin secretagogue, thiazolidinedione, or metformin in the prior 3 months * Initiation or dose adjustment, within the prior 3 months, of any of the following drugs or drug classes: fibrate, cholesterol binding resin, statin, niacin, or omega 3 fatty acid (fish oil). * Use of uridine, growth hormone, IGF-I, and growth hormone releasing factor analogues