Assessment of Endocrine Function in HIV-Infected Adolescent Girls at a Tertiary Centre in Zimbabwe. A Cross Sectional Study

Abstract Background: Proper planning of reproductive health needs for HIV-infected adolescents requires a clear understanding of the effects of HIV infection on adolescents’ pubertal development. Objective: To assess the effects of HIV infection on endocrine function in perinatally infected HIV adolescents. Methods: This was a cross-sectional survey of adolescent girls with perinatally acquired HIV aged 10-19 years, with reasonable immunological control who were attending an HIV clinic at a tertiary hospital in Zimbabwe. Consecutive sampling was used to select study participants, and adolescents who did not consent and those who were pregnant or acutely ill were excluded from the study. The data were collected using a standardised data collection tool. Pubertal milestones were assessed using age of menarche, thelarche, pubarche and Tanner stage for breast and pubic hair development. Growth was assessed using World Health Organisation growth charts. The hypothalamic-pituitary-gonadal axis was assessed by measuring the following serum hormones: follicular stimulating hormone (FSH), luteinising hormone (LH) and estradiol. Ovarian reserve was assessed in adolescents above 18 years of age by serum anti-mullein hormone (AMH) levels. Data were analysed in STATA version 13.0, and the results are presented as mean (SD) or median(quartiles) and proportions, as appropriate. Results: One hundred and one (101) HIV-infected adolescents were recruited for the study. Menarche, therlarche and pubarche were delayed in 15.9%, 28.6% and 46.8% of the adolescents, respectively. A total of 59.4% had moderate to severe stunting, and 53.5% were either overweight or obese. Serum AMH was reduced in 13.8% of the adolescents. Conclusion: HIV infection in adolescents is associated with stunted growth and delayed sexual maturation. There is a need for a larger study to examine ovarian aging in HIV-infected adolescents. Trial registration: This protocol was approved by the Medical Research Council of Zimbabwe (MRCZ) (reference number MRCZ/A/1730).