Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth

for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS)

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVE:: To evaluate the association between HIV infection and sexual maturation, and mediation of this association by HIV effects on growth. DESIGN:: Pooled data were analyzed from two longitudinal cohort studies, the IMPAACT P219/219C Study (1993–2007) and the PHACS Adolescent Master Protocol (2007–2015), including perinatally HIV-infected (PHIV) and HIV-exposed uninfected (PHEU) youth. METHODS:: We evaluated age at sexual maturity among 2539 PHIV and PHEU adolescents based on annual physician-assessed pubertal staging measures. Interval-censored regression models were used to evaluate associations of HIV infection with age at maturity. Mediation analyses accounting for height and body mass index (BMI) Z-scores at specific ages were used to estimate direct and indirect effects of HIV infection on age at sexual maturity. RESULTS:: Mean ages at sexual maturity for PHIV girls (n?=?1032) were 15.5 years for both female breast and pubic hair and 15.9 and 15.8 years for PHIV boys (n?=?1054) for genitalia and pubic hair, respectively. PHIV youth matured approximately 6 months later on average than PHEU (n?=?221 girls, 232 boys), and this difference persisted after adjustment for race/ethnicity and birth cohort. BMI and height Z-scores mediated the association between HIV infection and later maturation in girls, accounting for up to 74% of the total HIV effect. Only height Z-scores mediated the effect of HIV on male age at maturity, accounting for up to 98% of the HIV effect. CONCLUSION:: PHIV youth attain sexual maturity later on average than PHEU youth. Much of this difference may be attributable to deficient growth, suggesting directions for future interventions.

Original languageEnglish (US)
JournalAIDS
DOIs
StateAccepted/In press - Mar 29 2017

Fingerprint

Sexual Maturation
HIV
Growth
HIV Infections
Hair
Body Mass Index
Genitalia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS) (Accepted/In press). Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth. AIDS. https://doi.org/10.1097/QAD.0000000000001486

Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth. / for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS).

In: AIDS, 29.03.2017.

Research output: Contribution to journalArticle

for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS) 2017, 'Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth', AIDS. https://doi.org/10.1097/QAD.0000000000001486
for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS). Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth. AIDS. 2017 Mar 29. https://doi.org/10.1097/QAD.0000000000001486
for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS). / Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth. In: AIDS. 2017.
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title = "Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth",
abstract = "OBJECTIVE:: To evaluate the association between HIV infection and sexual maturation, and mediation of this association by HIV effects on growth. DESIGN:: Pooled data were analyzed from two longitudinal cohort studies, the IMPAACT P219/219C Study (1993–2007) and the PHACS Adolescent Master Protocol (2007–2015), including perinatally HIV-infected (PHIV) and HIV-exposed uninfected (PHEU) youth. METHODS:: We evaluated age at sexual maturity among 2539 PHIV and PHEU adolescents based on annual physician-assessed pubertal staging measures. Interval-censored regression models were used to evaluate associations of HIV infection with age at maturity. Mediation analyses accounting for height and body mass index (BMI) Z-scores at specific ages were used to estimate direct and indirect effects of HIV infection on age at sexual maturity. RESULTS:: Mean ages at sexual maturity for PHIV girls (n?=?1032) were 15.5 years for both female breast and pubic hair and 15.9 and 15.8 years for PHIV boys (n?=?1054) for genitalia and pubic hair, respectively. PHIV youth matured approximately 6 months later on average than PHEU (n?=?221 girls, 232 boys), and this difference persisted after adjustment for race/ethnicity and birth cohort. BMI and height Z-scores mediated the association between HIV infection and later maturation in girls, accounting for up to 74{\%} of the total HIV effect. Only height Z-scores mediated the effect of HIV on male age at maturity, accounting for up to 98{\%} of the HIV effect. CONCLUSION:: PHIV youth attain sexual maturity later on average than PHEU youth. Much of this difference may be attributable to deficient growth, suggesting directions for future interventions.",
author = "{for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS)} and Andrea Bellavia and Williams, {Paige L.} and Linda DiMeglio and Rohan Hazra and Abzug, {Mark J.} and Kunjal Patel and Jacobson, {Denise L.} and {van Dyke}, {Russell B.} and Geffner, {Mitchell E.}",
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T1 - Delay in sexual maturation in perinatally HIV-infected youth is mediated by poor growth

AU - for the International Maternal Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) P219219C Study, Pediatric HIVAIDS Cohort Study (PHACS)

AU - Bellavia, Andrea

AU - Williams, Paige L.

AU - DiMeglio, Linda

AU - Hazra, Rohan

AU - Abzug, Mark J.

AU - Patel, Kunjal

AU - Jacobson, Denise L.

AU - van Dyke, Russell B.

AU - Geffner, Mitchell E.

PY - 2017/3/29

Y1 - 2017/3/29

N2 - OBJECTIVE:: To evaluate the association between HIV infection and sexual maturation, and mediation of this association by HIV effects on growth. DESIGN:: Pooled data were analyzed from two longitudinal cohort studies, the IMPAACT P219/219C Study (1993–2007) and the PHACS Adolescent Master Protocol (2007–2015), including perinatally HIV-infected (PHIV) and HIV-exposed uninfected (PHEU) youth. METHODS:: We evaluated age at sexual maturity among 2539 PHIV and PHEU adolescents based on annual physician-assessed pubertal staging measures. Interval-censored regression models were used to evaluate associations of HIV infection with age at maturity. Mediation analyses accounting for height and body mass index (BMI) Z-scores at specific ages were used to estimate direct and indirect effects of HIV infection on age at sexual maturity. RESULTS:: Mean ages at sexual maturity for PHIV girls (n?=?1032) were 15.5 years for both female breast and pubic hair and 15.9 and 15.8 years for PHIV boys (n?=?1054) for genitalia and pubic hair, respectively. PHIV youth matured approximately 6 months later on average than PHEU (n?=?221 girls, 232 boys), and this difference persisted after adjustment for race/ethnicity and birth cohort. BMI and height Z-scores mediated the association between HIV infection and later maturation in girls, accounting for up to 74% of the total HIV effect. Only height Z-scores mediated the effect of HIV on male age at maturity, accounting for up to 98% of the HIV effect. CONCLUSION:: PHIV youth attain sexual maturity later on average than PHEU youth. Much of this difference may be attributable to deficient growth, suggesting directions for future interventions.

AB - OBJECTIVE:: To evaluate the association between HIV infection and sexual maturation, and mediation of this association by HIV effects on growth. DESIGN:: Pooled data were analyzed from two longitudinal cohort studies, the IMPAACT P219/219C Study (1993–2007) and the PHACS Adolescent Master Protocol (2007–2015), including perinatally HIV-infected (PHIV) and HIV-exposed uninfected (PHEU) youth. METHODS:: We evaluated age at sexual maturity among 2539 PHIV and PHEU adolescents based on annual physician-assessed pubertal staging measures. Interval-censored regression models were used to evaluate associations of HIV infection with age at maturity. Mediation analyses accounting for height and body mass index (BMI) Z-scores at specific ages were used to estimate direct and indirect effects of HIV infection on age at sexual maturity. RESULTS:: Mean ages at sexual maturity for PHIV girls (n?=?1032) were 15.5 years for both female breast and pubic hair and 15.9 and 15.8 years for PHIV boys (n?=?1054) for genitalia and pubic hair, respectively. PHIV youth matured approximately 6 months later on average than PHEU (n?=?221 girls, 232 boys), and this difference persisted after adjustment for race/ethnicity and birth cohort. BMI and height Z-scores mediated the association between HIV infection and later maturation in girls, accounting for up to 74% of the total HIV effect. Only height Z-scores mediated the effect of HIV on male age at maturity, accounting for up to 98% of the HIV effect. CONCLUSION:: PHIV youth attain sexual maturity later on average than PHEU youth. Much of this difference may be attributable to deficient growth, suggesting directions for future interventions.

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