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Review
. 2018 May;13(3):179-186.
doi: 10.1097/COH.0000000000000450.

Growth and pubertal development in HIV-infected adolescents

Paige L Williams  1 , Julie Jesson  2
Affiliations
Review

Growth and pubertal development in HIV-infected adolescents

Paige L Williams et al. Curr Opin HIV AIDS. 2018 May.

Abstract

Purpose of review: We present an overview of recent research in the inter-related areas of growth and pubertal development among adolescents with HIV. Growth deficits early in childhood can lead to delayed puberty, with subsequent effects on pubertal growth spurts and bone health.

Recent findings: Impaired growth remains a critical concern, particularly in low-resource settings, where stunting, wasting and underweight remain pervasive. Antiretroviral treatment (ART) initiation results in improved growth, with greatest growth recovery in the first years and more improvement in weight than in height. However, even years after ART initiation, growth deficits persist in low-resource settings (LRS), and adolescents appear at particularly increased risk. The high prevalence of stunting translates to delays in pubertal onset and sexual maturity. In contrast, HIV-infected adolescents in developed countries do not demonstrate persistent wasting, yet still have delayed pubertal development. Impaired growth increases the risk for mortality, virologic failure, and abnormal bone health, as well as increased depression and stigma.

Summary: Early initiation of ART across all age groups regardless of immunological status is essential for restoring growth. Coordination of ART initiation, nutritional supplementation programs, and concurrent prophylaxis is required to ameliorate growth deficits and pubertal delays, particularly in LRS.

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Conflict of interest statement

Conflicts of Interest: None

References

    1. [accessed 11/27/17];Number of people living with HIV: Adolescents (10–19) Available at http://aidsinfo.unaids.org.
    1. World Health Organization. [Accessed 12/1/2017];WHO 2007 Child Growth Standards. Available at: http://www.who.int/childgrowth/standards/en.
    1. Centers for Disease Control and Prevention. [Accessed 12/1/2017];Growth Charts. 2000 Available at https://www.cdc.gov/growthcharts/cdc_charts.htm.
    1. Barlow-Mosha L, Musiime V, Davies MA, et al. Universal antiretroviral therapy for HIV-infected children: a review of the benefits and risks to consider during implementation. J Int AIDS Soc. 2017 Jun 27;20(1):21552. This review highlights benefits of ART initiation on growth and puberty. - PMC - PubMed
    1. Goodarz D, Andrews KG, Sudfeld CR, et al. Risk factors for childhood stunting in 137 developing countries: A comparative risk assessment analysis at global, regional, and country levels. PLOS Med. 2016;13(11):e1002164. doi: 10.1371/journal/pmed.1002164. This study notes the relative role of HIV as a risk factor for malnutrition versus other risk factors in global context. - DOI - PMC - PubMed

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