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 Zilleruelo, Carolyn Abitbol, Warren A. Andiman, Kathleen A. Kaiser, Hans Spiegel, James M. Oleske

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


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 (US)
Pages (from-to)981-989
Number of pages9
JournalPediatric Nephrology
Issue number6
StatePublished - Jun 2012


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

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health


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