Antropometry in HIV patients: effects of recombinant human growth hormone

Abstract Patients with HIV infection treated with protease inhibitors (PIs) drugs for a long period have a prolonged life expectancy and an improvement of quality of life. Often, HIV-patients on PIs develop a syndrome characterized by peripheral lipoatrophy, truncal fat accumulation, hyperlipemia and insulin resistance. In HIV-1 patients undergoing antiretroviral treatment, lipodystrophy is associated with peripheral fat wasting and central adiposity, dyslipidemia, insulin resistance, and increased intramuscular fat accumulation. In HIV lipodystrophy fat distribution changes are heterogeneous and can include reduced subcutaneous fat and increased visceral fat. In literature there are evidences showing overnight growth hormone (GH) secretion and pulse amplitude reduction in patients with HIV lipodystrophy, in response to standard GH stimulation test. Excess accumulation of visceral fat with increasing of intra-abdominal adiposity (central obesity) is also a typical feature of patients with GH deficiency. Recombinant human growth hormone (rhGH) can be a useful treatment to diminish excess visceral fat. Up to day there are evidences that GH therapy in HIV-infected patients with syndromes of central fat accumulation show a significant decrease of body fat. In this chapter, we discuss the anthropometry of lipodystrophy in HIV patients and the indication of rhGH treatment in HIV-related lipodystrophy.