Research and Breakthroughs

Four Things You Didn’t Know About HIV and the Growing Child

From regulating our metabolism and mood to influencing overall growth and development, hormones intimately govern how our body works—especially during childhood and adolescence. But for youth with human immunodeficiency virus (HIV), infections and HIV-fighting antiretroviral medications can change the way these hormones act.

Mitchell E. Geffner, MD, and colleagues from across the U.S. – and in Puerto Rico—are studying the interaction between HIV and the hormone-producing endocrine system in the NIH-sponsored Pediatric HIV/AIDS Cohort Study (PHACS). Here are four key discoveries that Geffner’s group has made over the last few years:

  1. HIV may play a role in insulin resistance—and possibly the onset of diabetes—in affected adolescents.
  2. Children with HIV are more likely to have low bone mineral density, which can lead to osteoporosis and an increased risk of fractures.  
  3. Kids with HIV will enter puberty later than those who don’t have HIV.
  4. Children perinatally infected by HIV (meaning they were infected at or around their time of birth) have an increased risk of cardiovascular disease as they age which can be predicted by the severity of their HIV infection. 

“With the availability of better viral-specific drug therapies, the knowledge gleaned from this study will help to develop targeted monitoring and prevention strategies that ensure continued improvement in overall outcomes for HIV-infected children,“ said Geffner, who is Division Chief of the Center for Endocrinology, Diabetes, and Metabolism at CHLA.

Dimeglio LA et al., Bone mineral density in children and adolescents with perinatal HIV infection.  AIDS  2013;27:211-220.

Geffner ME et al., Factors associated with insulin resistance among children and adolescents perinatally-infected with HIV-1 in the Pediatric HIV/AIDS Cohort Study (PHACS).  Horm Res Paediatr. 2011;76:386-391.

Jacobson DL et al., Body fat distribution in perinatally HIV-infected and HIV-exposed but uninfected children in the era of highly active antiretroviral therapy:  Outcomes from the Pediatric HIV/AIDS Cohort Study (PHACS).  Amer J Clin Nutr  2011;94:1485-1495.

Miller TL et al., Metabolic abnormalities and viral replication associated with biomarkers of vascular dysfunction in HIV-Infected children.  HIV Med 2012;13:264-275.  

Williams PL et al., Pubertal onset in HIV-infected children in the era of combination antiretroviral treatment.  AIDS  2013;27:1959-1970.

Patel K et al., Aggregate risk of cardiovascular disease among adolescents perinatally infected with the human immunodeficiency. Circulation 2014;129:1204-1212.