Tesamorelin is a synthetic analog of human growth hormone-releasing hormone (GHRH) that plays a significant role in the regulation of growth hormone (GH) secretion. It is designed to stimulate endogenous GH production, thereby addressing metabolic complications associated with HIV, specifically excess abdominal fat accumulation observed in patients with HIV-associated lipodystrophy. Widely known under the brand name Egrifta, tesamorelin is the first and only pharmacological agent authorized for this condition, which is particularly pertinent among individuals with HIV infection (Dhillon, 2011; (Dhillon, 2011; (Spooner & Olin, 2012).

The drug’s mechanism primarily involves stimulating the secretion of GH from the anterior pituitary gland, which subsequently elevates levels of insulin-like growth factor-1 (IGF-1) in the serum (Adrian et al., 2019; Glesby et al., 2013). Elevated IGF-1 levels enhance the body’s capacity to mobilize visceral fat and have been reported to produce a concomitant reduction in triglyceride concentration (Mangili et al., 2015). In clinical trials, tesamorelin has effectively reduced visceral adiposity—defined as abdominal fat lying deep within the abdomen—and has shown positive trends in improving metabolic markers while maintaining a relatively mild impact on glucose homeostasis Sivakumar et al., 2011)(Spooner & Olin, 2012)Stanley et al., 2014).

Moreover, assessments of the drug’s efficacy highlight its role in improving patients’ overall quality of life by addressing not merely the aesthetic concerns related to body image but also the physiological effects of visceral fat, which include increased risks for cardiovascular disease and insulin resistance (Dhillon, 2011; Sivakumar et al., 2011). In particular, patients treated with tesamorelin have demonstrated notable decreases in visceral fat after 26 to 52 weeks of therapy, accompanied by improvements in lipid profiles and inflammatory markers (Spooner & Olin, 2012)Stanley et al., 2014).

Research has also suggested that tesamorelin may have neuroprotective benefits, as it has demonstrated potential cognitive benefits in populations both with and without HIV. Further clinical investigations are ongoing to explore the breadth of these effects, especially in conjunction with other therapeutic regimens, including integrase inhibitors (Masters et al., 2021).

It is critical to note that while tesamorelin benefits patients with HIV-associated lipodystrophy, there are considerations regarding long-term compliance and economic costs associated with therapy (Spooner & Olin, 2012). Nevertheless, its approval by the relevant regulatory bodies acknowledges its clinically significant advantages in managing a condition that significantly impairs the lives of many individuals living with HIV.