Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North India
Background Children living with human immunodeficiency virus (HIV) may experience growth failure and delay in sexual maturation. The aim of the study was to investigate sexual maturity rating and hormonal levels in children living with HIV aged 6-18 years. Material and methods In this cross-section...
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Termedia Publishing House
2024-11-01
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| Series: | HIV & AIDS Review. International Journal of HIV-Related Problems |
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| Online Access: | https://hivaids.termedia.pl/Sexual-maturity-staging-and-affecting-immune-hormonal-factors-in-children-aged-6,162055,0,2.html |
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| author | Ashwini Shivannavar Alok Hemal Hema Gupta Mittal |
| author_facet | Ashwini Shivannavar Alok Hemal Hema Gupta Mittal |
| author_sort | Ashwini Shivannavar |
| collection | DOAJ |
| description | Background
Children living with human immunodeficiency virus (HIV) may experience growth failure and delay in sexual maturation. The aim of the study was to investigate sexual maturity rating and hormonal levels in children living with HIV aged 6-18 years.
Material and methods
In this cross-sectional observational study over 18 months, 69 subsequent children living with HIV (CLHIV), aged between 6- and 18-years, attending antiretroviral therapy (ART) clinic were enrolled. Clearance from the Institutional Ethical Committee and informed consents were obtained.
Results
Baseline data of 69 children showed male predominance (66.7%), vertical transmission (95.7%), normal body mass index (BMI) (71%), immunocompetency (3/4th), and low viral load (2/3rd). Sexual maturity staging revealed that the majority were pre-pubertal (pubic hair (PH) stage 1: boys = 54.3%, girls = 39.1%; testicular volume stage 1 = half; breast stage 1 = 39.1%). Delayed puberty was observed in 6.5% of boys and 8.6% of girls. The mean age of menarche was 13 ± 1.4 years. Hormonal levels between boys and girls showed statistically significant difference in levels of follicular stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estrogen, and Free androgen index (FAI). Luteinizing hormone had high sensitivity and specificity (cut-off value = 1.06, sensitivity = 95.5%, specificity = 83.3%) for predicting stage 2 of testicular volume (gonadarche), and in girls (cut-off value = 1.74, sensitivity = 92.9%, specificity = 88.9%). For FSH in girls, cutoff value of 5.42 provided high sensitivity (92.9%) in predicting thelarche (breast stage 2). No statistically significant association was observed with CD4 categories (p = 0.3), viral load categories (p = 0.2), age at ART initiation, and BMI categories with pubertal stages. Among antiretroviral drugs, less than 50% of children on abacavir, zidovudine, and lopinavir/ritonavir had attained pubertal onset (in girls, breast stage ≥ 2; in boys, testicular volume (TV) stage ≥ 2).
Conclusions
Delayed puberty was observed in 6.5% of boys and 8.6% of girls. Median ages at thelarche and gonadarche were higher in included children when compared to healthy school going children. HIV infection may have a negative effect on the sexual maturity rating in CLHIV. |
| format | Article |
| id | doaj-art-64c83279562c4a6eb24dba3d3e8d4548 |
| institution | Kabale University |
| issn | 1730-1270 1732-2707 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | HIV & AIDS Review. International Journal of HIV-Related Problems |
| spelling | doaj-art-64c83279562c4a6eb24dba3d3e8d45482025-01-27T11:06:39ZengTermedia Publishing HouseHIV & AIDS Review. International Journal of HIV-Related Problems1730-12701732-27072024-11-0123432332910.5114/hivar/162055162055Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North IndiaAshwini Shivannavar0Alok Hemal1Hema Gupta Mittal2Atal Bihari Vajapayee Institute of Medical Sciences and Ram Manohar Lohia Hospital, New Delhi, IndiaAtal Bihari Vajapayee Institute of Medical Sciences and Ram Manohar Lohia Hospital, New Delhi, IndiaAtal Bihari Vajapayee Institute of Medical Sciences and Ram Manohar Lohia Hospital, New Delhi, IndiaBackground Children living with human immunodeficiency virus (HIV) may experience growth failure and delay in sexual maturation. The aim of the study was to investigate sexual maturity rating and hormonal levels in children living with HIV aged 6-18 years. Material and methods In this cross-sectional observational study over 18 months, 69 subsequent children living with HIV (CLHIV), aged between 6- and 18-years, attending antiretroviral therapy (ART) clinic were enrolled. Clearance from the Institutional Ethical Committee and informed consents were obtained. Results Baseline data of 69 children showed male predominance (66.7%), vertical transmission (95.7%), normal body mass index (BMI) (71%), immunocompetency (3/4th), and low viral load (2/3rd). Sexual maturity staging revealed that the majority were pre-pubertal (pubic hair (PH) stage 1: boys = 54.3%, girls = 39.1%; testicular volume stage 1 = half; breast stage 1 = 39.1%). Delayed puberty was observed in 6.5% of boys and 8.6% of girls. The mean age of menarche was 13 ± 1.4 years. Hormonal levels between boys and girls showed statistically significant difference in levels of follicular stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estrogen, and Free androgen index (FAI). Luteinizing hormone had high sensitivity and specificity (cut-off value = 1.06, sensitivity = 95.5%, specificity = 83.3%) for predicting stage 2 of testicular volume (gonadarche), and in girls (cut-off value = 1.74, sensitivity = 92.9%, specificity = 88.9%). For FSH in girls, cutoff value of 5.42 provided high sensitivity (92.9%) in predicting thelarche (breast stage 2). No statistically significant association was observed with CD4 categories (p = 0.3), viral load categories (p = 0.2), age at ART initiation, and BMI categories with pubertal stages. Among antiretroviral drugs, less than 50% of children on abacavir, zidovudine, and lopinavir/ritonavir had attained pubertal onset (in girls, breast stage ≥ 2; in boys, testicular volume (TV) stage ≥ 2). Conclusions Delayed puberty was observed in 6.5% of boys and 8.6% of girls. Median ages at thelarche and gonadarche were higher in included children when compared to healthy school going children. HIV infection may have a negative effect on the sexual maturity rating in CLHIV.https://hivaids.termedia.pl/Sexual-maturity-staging-and-affecting-immune-hormonal-factors-in-children-aged-6,162055,0,2.htmlchildren living with hivpubertytanner’s stageslhfshtestosterone |
| spellingShingle | Ashwini Shivannavar Alok Hemal Hema Gupta Mittal Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North India HIV & AIDS Review. International Journal of HIV-Related Problems children living with hiv puberty tanner’s stages lh fsh testosterone |
| title | Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North India |
| title_full | Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North India |
| title_fullStr | Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North India |
| title_full_unstemmed | Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North India |
| title_short | Sexual maturity staging and affecting immune-hormonal factors in children aged 6-18 years living with HIV: experience from tertiary care center in North India |
| title_sort | sexual maturity staging and affecting immune hormonal factors in children aged 6 18 years living with hiv experience from tertiary care center in north india |
| topic | children living with hiv puberty tanner’s stages lh fsh testosterone |
| url | https://hivaids.termedia.pl/Sexual-maturity-staging-and-affecting-immune-hormonal-factors-in-children-aged-6,162055,0,2.html |
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