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Pathophysiology of GHRH-growth hormone-IGF1 axis in HIV/AIDS

  • Shobhit Jain
  • Ninad Desai
  • Amrit Bhangoo
Article

Abstract

Aberrations in GHRH—GH –IGF-I axis are common in the complex of HIV, HAART and AIDS. There are 2 distinct mechanisms at play in HIV and AIDS. One is primarly associated with development of lipodystrophy and results in complications such as chronic inflammation, insulin resistance, lipid and metabolic abnormalities. HIV lipodystrophy is found especially in those on highly active anti-retroviral therapy (HAART). The various processes involved in lipodystrophy result in the suppression of pituitary GH production. The mechanism of low GH levels relates to increased somatostatin tone, decreased Ghrelin, increased free fatty acids (FFA) and insulin resistance. On the other hand in AIDS wasting syndrome; elevated GH and low IGF-1 levels are seen suggesting GH resistance. The GHRH analog—Tesamorelin is the only treatment option, which is FDA approved for use in reduction of excess abdominal fat in patients with HIV-associated lipodystrophy. Although long-term clinical trials and experience is needed to further study the benefits and risks of Tesamorelin.

Keywords

HIV Lipodystrophy AIDS wasting syndrome GH GHRH Tesamorelin 

Abbreviations

GH

Growth hormone

GHRH

Growth hormone releasing hormone

HIV

Human immunodeficiency virus

AIDS

Acquired immunodeficiency syndrome

IGF-I

Insulin like growth factor-I

IGFBP-3

IGF binding protein-3

HAART

Highly active anti-retroviral therapy

Notes

Conflict of interest

None to declare

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of PediatricsSUNY Downstate Medical Center & Kings County Hospital CenterBrooklynUSA
  2. 2.Division of Pediatric EndocrinologySUNY Downstate Medical Center & Kings County Hospital CenterBrooklynUSA

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