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Delay in sexual maturation in perinatally HIV-infected youths is mediated by poor growth.

ABSTRACT: OBJECTIVE:To evaluate the association between HIV infection and sexual maturation, and mediation of this association by HIV effects on growth. DESIGN:Pooled data were analyzed from two longitudinal cohort studies, the International Maternal Pediatric Adolescent AIDS Clinical Trials P219/219C Study (1993-2007) and the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (2007-2015), including perinatally HIV-infected (PHIV) and HIV-exposed uninfected (PHEU) youths. METHODS:We evaluated age at sexual maturity among 2539 PHIV and PHEU adolescents based on annual physician-assessed pubertal staging measures. Interval-censored regression models were used to evaluate associations of HIV infection with age at maturity. Mediation analyses accounting for height and BMI Z-scores at specific ages were used to estimate direct and indirect effects of HIV infection on age at sexual maturity. RESULTS:Mean ages at sexual maturity for PHIV girls (n?=?1032) were 15.5 years for both female breast and pubic hair and 15.9 and 15.8 years for PHIV boys (n?=?1054) for genitalia and pubic hair, respectively. PHIV youths matured approximately 6 months later on average than PHEU (n?=?221 girls and 232 boys), and this difference persisted after adjustment for race/ethnicity and birth cohort. BMI and height Z-scores mediated the association between HIV infection and later maturation in girls, accounting for up to 74% of the total HIV effect. Only height Z-scores mediated the effect of HIV on male age at maturity, accounting for up to 98% of the HIV effect. CONCLUSION:PHIV youths attain sexual maturity later on average than PHEU youths. Much of this difference may be attributable to deficient growth, suggesting directions for future interventions.

SUBMITTER: Bellavia A

PROVIDER: S-EPMC5472204 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Delay in sexual maturation in perinatally HIV-infected youths is mediated by poor growth.

Bellavia Andrea A Williams Paige L PL DiMeglio Linda A LA Hazra Rohan R Abzug Mark J MJ Patel Kunjal K Jacobson Denise L DL Van Dyke Russell B RB Geffner Mitchell E ME

AIDS (London, England) 20170601 9

<h4>Objective</h4>To evaluate the association between HIV infection and sexual maturation, and mediation of this association by HIV effects on growth.<h4>Design</h4>Pooled data were analyzed from two longitudinal cohort studies, the International Maternal Pediatric Adolescent AIDS Clinical Trials P219/219C Study (1993-2007) and the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (2007-2015), including perinatally HIV-infected (PHIV) and HIV-exposed uninfected (PHEU) youths.<h4>Methods ...[more]

PMID: 28358737

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Project description:BackgroundIncreased incidence and prevalence of asthma have been documented for perinatally HIV-infected youth 10 to 21 years of age compared with HIV-exposed uninfected (HEU) youth.ObjectiveWe sought to perform objective pulmonary function tests (PFTs) in HIV-infected and HEU youth with and without diagnosed asthma.MethodAsthma was determined in 370 participants (218 HIV-infected and 152 HEU participants) by means of chart review and self-report at 13 sites. Interpretable PFTs (188 HIV-infected and 132 HEU participants) were classified as obstructive, restrictive, or normal, and reversibility was determined after bronchodilator inhalation. Values for HIV-1 RNA, CD4 and CD8 T cells, eosinophils, total IgE, allergen-specific IgE, and urinary cotinine were measured. Adjusted prevalence ratios (PRs) of asthma and PFT outcomes were determined for HIV-infected participants relative to HEU participants, controlling for age, race/ethnicity, and sex.ResultsCurrent asthma was identified in 75 (34%) of 218 HIV-infected participants and 38 (25%) of 152 HEU participants (adjusted PR, 1.33; P = .11). The prevalence of obstructive disease did not differ by HIV status. Reversibility was less likely in HIV-infected youth than in HEU youth (17/183 [9%] vs 21/126 [17%]; adjusted PR, 0.47; P = .020) overall and among just those with obstructive PFT results (adjusted PR, 0.46; P = .016). Among HIV-infected youth with current asthma, serum IgE levels were inversely correlated with CD8 T-cell counts and positively correlated with eosinophil counts and not associated with CD4 T-cell counts. HIV-infected youth had lower association of specific IgE levels to several inhalant and food allergens compared with HEU participants and significantly lower CD4/CD8 T-cell ratios (suggesting immune imbalance).ConclusionCompared with HEU youth, HIV-infected youth demonstrated decreased reversibility of obstructive lung disease, which is atypical of asthma. This might indicate an early stage of chronic obstructive pulmonary disease. Follow-up into adulthood is warranted to further define their pulmonary outcomes.

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Delay in sexual maturation in perinatally HIV-infected youths is mediated by poor growth.

Publications

Delay in sexual maturation in perinatally HIV-infected youths is mediated by poor growth.

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