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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
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Minerva Pediatrica 2006 October;58(5):461-7

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Hormonal, auxological and clinical follow-up in children with connatal HIV infection Personal records

Titone L., Maggio M. C., Di Carlo P., Romano A., Teresi S., Guicciardino E., Saitta M., Liotta A.

1 Institute of Infectious Diseases and Virology University of Palermo, Palermo, Italy 2 Department of Pediatrics University of Palermo, Palermo, Italy 3 Assays Laboratory of Children Hospital G. Di Cristina, Palermo, Palermo, Italy


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Aim. HIV infection and antiretroviral drugs have relevant endocrine implications, affecting growth and pubertal development. Moreover stature impairment cannot depend only on decreased hormonal secretion.
Methods. We studied for 7 years growth, puberty, bone maturation, hormonal secretion [Growth Hormone (GH) basal and after stimulation with Clonidin and Insulin, Insulin-like Growth Factor 1 (IGF-1), Insulin-like Growth Factor Binding Protein 3 (IGFBP-3), FSH, LH- gonadic hormones axis, ACTH, Cortisol, TSH, fT4, T4, T3, anti-thyroid antibodies, Leptin] of 10 HIV-infected children.
Results. In 3 patients stature was <-2 SDS in the first 2 years and in prepubertal age, with intervals of improved growth. The weight was >2 SDS in 6 children, <-2 SDS in 1 girl, while the other 3 patients had a weight <-2SDS only in the first 2 years of life. Height growth velocity was >10°Centile all over the years of follow-up in 9 patients, while weight growth velocity was pathological in 5. Leptinemia showed higher levels at the beginning of follow up: 0.82-11.68 ng/L (M±DS: 3.29±4.15) than at the end of the study: 0.2-3 ng/L (M±DS: 1.65±1.01). Leptin levels showed a statistically significant correlation with CD4/CD8 count (P: 0.010; r: 0.916) and with the CDC stage (P: 0.006; r: 0.937), meaning a strong link to the severity of the disease.
Conclusions. A good clinical control of HIV infection can guarantee growth within physiological centile in most of HIV-infected children. Over all IGFBP-3 and IGF-1 are good markers of growth, more usable than GH.

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