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

  • Shobhit Jain
  • Ninad Desai
  • Amrit Bhangoo


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.


HIV Lipodystrophy AIDS wasting syndrome GH GHRH Tesamorelin 



Growth hormone


Growth hormone releasing hormone


Human immunodeficiency virus


Acquired immunodeficiency syndrome


Insulin like growth factor-I


IGF binding protein-3


Highly active anti-retroviral therapy


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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