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 essential component of the endocrine system for stimulating postnatal growth in children and maintaining lean body mass in adults. It may be more than coincidental, therefore, that impaired growth and muscle wasting are common symptoms of human immunodeficiency virus (HIV) infection in children and adults. Wasting and growth failure contribute significantly to the morbidity and mortality associated with AIDS. Multiple defects in the GH/IGF axis have been reported in patients with AIDS. These include abnormal GH secretion and tissue responsiveness, diminished serum concentrations of IGF-I and -II, and abnormal post-translational modifications of IGF binding proteins. In this review we examine the hypothesis that the failure to thrive (in children) and the loss of lean body mass (in adults) may be age-related manifestations of AIDS that, in part, result from defects in the GH/IGF axis.