Growth hormone deficiency with successful treatment of HIV infection

Abstract

Watson and Counts describe two well-documented cases of growth failure and growth hormone deficiency in children congenitally infected with HIV. Timing of growth failure despite control of HIV replication, as well as laboratory data, suggest an acquired growth hormone deficiency. The authors postulate antiretroviral drug toxicity or HIV effect as causes of growth hormone deficiency. Of 113 children being treated for HIV infection at the University of Maryland, these two cases were the only incidences of abnormal velocity of growth in height. Both children had accelerated growth velocity following growth hormone therapy. Previously, stunted growth was the common effect of uncontrolled HIV infection. With control of infection, expectations for growth have changed, and also, apparently, the likely cause for the few who do not grow normally. Also, in this issue, investigators Vigano et al show that growth hormone-related thymic and post-thymic immunologic pathways can still be abnormal in children whose HIV replication is controlled.