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Pediatr Nephrol. 2012 Jun;27(6):981-9. doi: 10.1007/s00467-011-2097-1. Epub 2012 Feb 26.

Chronic kidney disease associated with perinatal HIV infection in children and adolescents.

Author information

1
Department of Pediatrics, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY 10457, USA. mpurswan@bronxleb.org

Abstract

BACKGROUND:

This study describes the incidence, clinical and demographic characteristics, and spectrum of chronic kidney disease (CKD) in youths with perinatal HIV-1 infection.

METHODS:

Retrospective analysis between May 1993 and December 2006 of subjects with renal disease followed in the Pediatric AIDS Clinical Trials Group 219/219C multicenter study examining the long-term consequences of perinatal HIV infection. Diagnosis confirmation was made utilizing a questionnaire mailed to research sites. Participants with CKD of other etiology than HIV were excluded. Outcome measures were biopsy-diagnosed CKD and, in the absence of biopsy, HIV-associated nephropathy (HIVAN) using established clinical criteria.

RESULTS:

Questionnaires on 191 out of 2,102 participants identified 27 cases of CKD: 14 biopsy-diagnosed and 6 clinical cases of HIVAN, and 7 biopsy-diagnosed cases of immune complex-mediated kidney disease (lupus-like nephritis, 3; IgA nephropathy, 2; membranous nephropathy, 2). Incidence rates for CKD associated with HIV in pre-highly active antiretroviral therapy (HAART) (1993-1997) and HAART (1998-2002, 2003-2006) eras were 0.43, 2.84, and 2.79 events per 1,000 person years respectively. In multivariate analysis, black race and viral load ā‰„100,000 copies/mL (rate ratios 3.28 and 5.05, pā€‰ā‰¤ā€‰0.02) were associated with CKD.

CONCLUSIONS:

A variety of immune complex-mediated glomerulonephritides and HIVAN occurs in this population. Black race and uncontrolled viral replication are risk factors for CKD associated with HIV.

PMID:
22366874
PMCID:
PMC3715373
DOI:
10.1007/s00467-011-2097-1
[Indexed for MEDLINE]
Free PMC Article

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