AIDSWEEKLY Plus; Monday, September 3, 2001
Michael Greer, Staff Medical Writer

NewsRx - Health care workers providing treatment for adolescents infected with HIV at birth may need to deal with psychological issues stemming from delayed puberty, researchers in Italy say.

Maurizio de Martino and colleagues at the University of Florence and the Universities of Turin, Chieti, Genoa, Padua, Breacia, and Pavia, as well as Careggi Hospital in Florence and Bambino Geso Children's Hospital in Rome, conducted a study to "define age at entry into Tanner stages in children with perinatal HIV-1 infection."

Sexual maturation is markedly delayed in perinatally infected adolescents, especially in girls, Martino and coworkers found.

Infected boys entered Tanner stage II - generally considered the beginning of puberty - at an average age of 12.6 years, study data showed. The 105 young male patients studied fell between the 75th and 97th percentile of age at puberty onset and could expect up to a 15 month delay in reaching this level of maturity.

Perinatally infected girls demonstrated an even more pronounced delay in the onset of puberty, the researchers found. While girls usually begin maturing roughly a year before boys, the female adolescents in this study did not reach Tanner stage II until an average age of 12.9 years, slightly later than their male counterparts. This placed them in the 97th percentile or higher, according to the report, with an expected delay of 21 months or longer.

The extent of disease progression, treatment experience, immune status, and other clinical factors did not significantly affect the age of puberty onset ("Puberty in perinatal HIV-1 infection: A multicentre longitudinal study of 212 children," AIDS 2001 Aug 17;15(12):1527-1534.

"Perinatal HIV-1 infection interferes with sexual maturation. The mechanisms by which this occurs should be elucidated and intervention strategies designed," Martino and coauthors concluded. "Intervention could save much psychological distress, since associated linear growth failure can exacerbate adolescents' feelings of being different and unwell."

The corresponding author for this report is Maurizio de Martino, Department of Paediatrics, University of Florence, Via Luca Giordano 13, I-50132 Florence, Italy.

Key points reported in this study include:

• Children who were perinatally infected with HIV are likely to experience a delay in the onset of puberty
  


• This delay was much more pronounced in girls than in boys
  


• The onset of puberty in perinatally infected girls was roughly two years later than in healthy girls
  

This article was prepared by AIDS Weekly editors from staff and other reports.

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