Clinical review comparing growth hormone and tesamorelin for HIV-associated lipodystrophy management, covering the limitations of supraphysiologic rhGH therapy (insulin resistance, lipoatrophy exacerbation), tesamorelin's advantages as a GHRH analog that restores physiological GH pulsatility, clinical trial outcomes, FDA approval, and practical prescribing guidance. Positions tesamorelin as the preferred GH-axis intervention. Establishes tesamorelin's clinical advantages over direct rhGH therapy in HIV lipodystrophy—explaining how physiological GHRH stimulation achieves visceral fat reduction with fewer metabolic adverse effects and providing practitioners with evidence-based guidance for selecting between GH-axis treatment options.
Bedimo, Roger