Delayed onset of puberty (DP) was a recognized complication of perinatal HIV infection in the pre-HAART era. The aim of this study was to determine the prevalence of and risk factors for DP among perinatally HIV-infected children during the HAART era.
Retrospective chart abstraction was performed in LEGACY, a longitudinal observational cohort of perinatally HIV-infected children and youth (0-24 years) enrolled from 22 U.S. HIV clinics during 2004-2006. Subjects with complete chart abstraction (N=451) were included in this analysis if they had onset of puberty documented by at least two Tanner stage (TS) assessments between 2000 and 2006. DP was defined as not achieving TS II by age 12 years for girls and by age 14 years for boys. We compared demographic and clinical factors of subjects with and without DP using the chi-square test and multivariable logistic regression.
Inclusion criteria were met by 131 (53.2%) of 246 girls and 103 (50.2%) of 205 boys. DP occurred in 7 (5.3%, 95% CI 1.5%, 9.2%) girls and 4 (3.9%, 95% CI 0.2%, 7.6%) boys. The average age of entry into TS II was 10.5 years for girls and 11.4 years for boys. Median duration of antiretroviral exposure was 10.8 vs. 8.5 years for children who experienced DP and non-DP, respectively (p > 0.05). CD4 cell count (CD4) at TS assessment < 200 compared with > 200 cells/mm3 was associated with DP for both girls and boys (29% vs. 2% and 50% vs. 5%, both p = 0.001). In a multiple regression analysis controlling for gender, both Hispanic vs. non-Hispanic ethnicity (OR = 4.1, 95% CI 1.0, 16.3) and a CD4 < 200 vs. > 200 cells/mm3 (OR = 22.7, 95% CI=4.5, 115.8) were associated with DP.
Most perinatally HIV-infected children receiving HAART do not have delayed onset of puberty. Immunosuppression and Hispanic ethnicity were associated with DP in this cohort of perinatally HIV-infected children.
G. Del Bianco,
T. Frederick, None
T. Wheeling, None
B. Bohannon, None
K. Dominguez, None
G. Siberry, None
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