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

Murli U. Purswani, Miriam C. Chernoff, Charles D Mitchell, George R. Seage, Gaston E Zilleruelo, Carolyn Abitbol, Warren A. Andiman, Kathleen A. Kaiser, Hans Spiegel, James M. Oleske

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18 Scopus citations

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 ≥100,000 copies/mL (rate ratios 3.28 and 5.05, p≤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.

Original languageEnglish
Pages (from-to)981-989
Number of pages9
JournalPediatric Nephrology
Volume27
Issue number6
DOIs
StatePublished - Jun 1 2012

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Keywords

  • Biopsy
  • FSGS
  • HIV immune complex kidney disease
  • HIVAN
  • Proteinuria
  • Renal
  • Youth

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Purswani, M. U., Chernoff, M. C., Mitchell, C. D., Seage, G. R., Zilleruelo, G. E., Abitbol, C., Andiman, W. A., Kaiser, K. A., Spiegel, H., & Oleske, J. M. (2012). Chronic kidney disease associated with perinatal HIV infection in children and adolescents. Pediatric Nephrology, 27(6), 981-989. https://doi.org/10.1007/s00467-011-2097-1