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Growth impairment, IGF I hyposecretion and thyroid dysfunction in children with perinatal HIV-1 infection
P Matarazzo1, E Palomba, R Lala
1Department of Paediatric Endocrinology, Regina Margherita Children's Hospital, Turin, Italy.
Insights
Perinatally infected children show impaired growth and delayed bone age, with reduced insulin-like growth factor I (IGF I) levels. These growth markers can monitor HIV disease progression.
Area of Science:
- Pediatrics
- Infectious Diseases
- Endocrinology
Background:
- Perinatal HIV infection can impact child development.
- Growth patterns and endocrine function are sensitive to chronic illness.
Purpose of the Study:
- To assess growth, bone age, IGF I, and thyroid function in perinatally HIV-infected children.
- To compare these parameters between asymptomatic/paucisymptomatic and treated advanced HIV disease groups.
- To evaluate their utility in monitoring disease progression.
Main Methods:
- Longitudinal evaluation of 24 perinatally HIV-infected children (9 asymptomatic/paucisymptomatic, 15 treated for advanced disease).
- Comparison with 37 HIV-seroreverted children over a two-year follow-up.
- Assessment of statural and ponderal growth, bone age, IGF I levels, and thyroid function.
Main Results:
- Asymptomatic/paucisymptomatic children showed impaired growth (22%), bone age delay (33%), and reduced IGF I (45%).
- Children with advanced HIV disease had higher rates of growth failure (53%), bone age delay (53%), reduced IGF I (86%), and thyroid dysfunction (40%).
- Seroreverted children had no growth impairment; significant differences in height, weight, and height velocity were observed compared to infected children.
Conclusions:
- Auxological and hormonal parameters correlate with the clinical status of perinatal HIV infection.
- IGF I levels and growth parameters are valuable indicators for monitoring HIV disease progression in children.
- Early detection and monitoring of growth disturbances are crucial in managing perinatally HIV-infected children.
Abstract:
We evaluated the growth pattern, bone age, insulin-like growth factor I (IGF I) secretion and thyroid function in 24 perinatally infected children: 9 asymptomatic or paucisymptomatic (group 1) and 15 with a more advanced disease state and treated with zidovudine (group 2). Statural and ponderal growth were compared with those of 37 at-risk children who seroreverted. During the two-year follow-up, 22% of children in group 1 had impaired growth, 33% bone age delay, 45% reduced IGF I levels but none had thyroid dysfunction. In group 2, 53% had growth failure, 53% bone age delay, 86% reduced IGF I levels and 40% thyroid dysfunction. Among seroreverters, none showed growth impairment; statistically significant differences were found for height, weight and height velocity between perinatally infected children and seroreverters. Since auxological and hormonal evaluations run parallel to the clinical course of infection, these indices may be useful in monitoring disease progression.