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- Title
Chronic kidney disease associated with perinatal HIV infection in children and adolescents.
- Authors
Purswani, Murli; Chernoff, Miriam; Mitchell, Charles; Seage, George; Zilleruelo, Gaston; Abitbol, Carolyn; Andiman, Warren; Kaiser, Kathleen; Spiegel, Hans; Oleske, James
- 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.
- Subjects
PUERTO Rico; UNITED States; HIV infection epidemiology; AIDS complications; BLACK people; BLOOD cell count; CHI-squared test; CHRONIC kidney failure; CONFIDENCE intervals; FISHER exact test; KIDNEY diseases; MEDICAL cooperation; POISSON distribution; QUESTIONNAIRES; RACE; RESEARCH; RESEARCH funding; STATISTICS; T cells; T-test (Statistics); WHITE people; DATA analysis; VIRAL load; MULTIPLE regression analysis; HIGHLY active antiretroviral therapy; DISEASE incidence; RETROSPECTIVE studies; DATA analysis software; DISEASE risk factors
- Publication
Pediatric Nephrology, 2012, Vol 27, Issue 6, p981
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-011-2097-1