HIV-associated immune dysfunction and delayed pubertal development in a cohort of young hemophiliacs

As part of the Hemophilia Growth and Development Study (HGDS), we investiga ted the relationship between HIV-associated immune dysfunction and delayed pubertal development in a cohort of 333 boys and adolescents with moderate or severe hemophilia who were between the ages of 6 and 19 years at study e ntry in 1989. Sixty-two percent of the cohort was infected with HIV in the late 1970s and early 1980s through exposure to contaminated clotting factor concentrates. The cohort was observed during follow-up at 6-month interval s; measurements taken at each follow-up visit included Tanner stage and CD4 (+) cell count. This analysis of data from the first 4 years of follow-up r evealed statistically significant delays in pubertal development associated with increasing levels of immune dysfunction. Our results emphasize the im portance of following pubertal development in HIV-infected adolescent boys since delays in maturation may reflect underlying disease progression.