GROWTH-HORMONE INSULIN-LIKE GROWTH-FACTOR AXIS IN HUMAN-IMMUNODEFICIENCY-VIRUS ASSOCIATED DISEASE

The growth hormone (GH)/insulin-like growth factor (IGF) axis is an es sential component of the endocrine system for stimulating postnatal gr owth in children and maintaining lean body mass in adults. It may be m ore than coincidental, therefore, that impaired growth and muscle wast ing are common symptoms of human immunodeficiency virus (HIV) infectio n in children and adults. Wasting and growth failure contribute signif icantly to the morbidity and mortality associated with AIDS. Multiple defects in the GH/IGF axis have been reported in patients with AIDS. T hese include abnormal GH secretion and tissue responsiveness, diminish ed serum concentrations of IGF I and II, and abnormal post-translation al modifications of IGF binding proteins. In this review we examine th e hypothesis that the failure to thrive (in children) and the loss of lean body mass (in adults) may be age related manifestations of AIDS t hat, in part, result from defects in the GH/IGF axis.