Puberty in perinatal HIV-1 infection: a multicentre longitudinal study of 212 children

Objective: To define age at entry into Tanner stages in children with perin atal HIV-1 infection. Design: Multicentre longitudinal study including 212 perinatally HIV-1-infe cted children (107 girls and 105 boys) followed-up during puberty (from 8 a nd 9 years onwards in girls and boys, respectively). Healthy children (843 girls and 821 boys) provided reference percentiles. P2 or B2 stages in girl s and P2 or G2 stages in boys defined onset of puberty. Methods: The cumulative probability [95% confidence limit (CI)] of entry in to each stage at different ages was estimated by the Kaplan-Meier product-l imit method; differences were evaluated by log rank test. Relationships wer e tested using the Spearman's rank correlation coefficient. Results: Ages of girls [years (95%CI)] at P2 [12.9 (12.6-13.2)], P3 [13.4 ( 13.0-13.8)], P4 [14.6 (14.0-15.2)], B2 [12.7 (12.2-13.2)], B3 [13.3 (12.8-1 4.0)] and B4 [14.6 (14.0-15.2)] stages were > 97th percentile (greater than or equal to 21 month delay) of controls. Ages of boys [years(95%CI)] at P2 [12.6(12.1-13.1)], P3 [13.9 (13.4-14.4)], P4 [14.9 (14.2-15.6)], G2 [12.1 (11.5-12.7)], G3 [13.6 (13.1-14.1)] and G4 [14.9 (14.1-15.7)] stages were a t the 75-97th percentiles (less than or equal to 15 month delay). Age at on set of puberty was not related to clinical and immunological condition, ant iretroviral treatment, weigh for height and age at onset of severe disease or immune suppression. Conclusion: Perinatal HIV-1 infection interferes with sexual maturation. Th e mechanisms by which this occurs should be elucidated and intervention str ategies designed. Intervention could save much psychological distress, sinc e associated linear growthfailure can exacerbate adolescents' feelings of b eing different and unwell. (C) 2001 Lippincott Williams & Wilkins.