ORIGINAL ARTICLES   

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

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.