TABLE 5.

Adolescent-specific issues

• Exposure during adolescence and throughout adulthood to infection and inflammation and exposure to ART1 that collectively may contribute to

• Impaired longitudinal growth

• Delayed puberty

• Impaired accrual or actual loss of bone mass

• Alterations in fat mass and distribution

• Dyslipidemia

• Insulin resistance, diabetes

• Altered cardiac function

• Accelerated cardiovascular disease (increased carotid intima media thickness)

• Impairment in cognitive function or other neurologic issues

• End-organ disease secondary to HIV or ART

• Adherence to ART is challenging for many HIV-infected youth

• Developmental differences in pharmacokinetics/dynamics that may affect ART and potential impact on safety and effectiveness

• Pregnancy in HIV-infected adolescents confers additional risk

• Adolescents’ relatively robust immune systems, along with potential positive impact of nutritional support and healthy lifestyle choices, might delay HIV progression and time to ART in recently infected adolescents

¹ART, antiretroviral therapy.