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

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18 Citations (Scopus)

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

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Chronic Renal Insufficiency
HIV Infections
AIDS-Associated Nephropathy
Biopsy
Highly Active Antiretroviral Therapy
HIV
Antigen-Antibody Complex
Membranous Glomerulonephritis
Lupus Nephritis
Kidney Diseases
Glomerulonephritis
Viral Load
Immunoglobulin A
Multicenter Studies
HIV-1
Acquired Immunodeficiency Syndrome
Cohort Studies
Multivariate Analysis
Demography
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Keywords

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

Cite this

Purswani, M. U., Chernoff, M. C., Mitchell, C. D., Seage, G. R., Zilleruelo, G., Abitbol, C., ... 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
Purswani, Murli U. ; Chernoff, Miriam C. ; Mitchell, Charles D. ; Seage, George R. ; Zilleruelo, Gaston ; Abitbol, Carolyn ; Andiman, Warren A. ; Kaiser, Kathleen A. ; Spiegel, Hans ; Oleske, James M. / Chronic kidney disease associated with perinatal HIV infection in children and adolescents. In: Pediatric Nephrology. 2012 ; Vol. 27, No. 6. pp. 981-989.
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Purswani, MU, Chernoff, MC, Mitchell, CD, Seage, GR, Zilleruelo, G, Abitbol, C, Andiman, WA, Kaiser, KA, Spiegel, H & Oleske, JM 2012, 'Chronic kidney disease associated with perinatal HIV infection in children and adolescents', Pediatric Nephrology, vol. 27, no. 6, pp. 981-989. https://doi.org/10.1007/s00467-011-2097-1

Chronic kidney disease associated with perinatal HIV infection in children and adolescents. / Purswani, Murli U.; Chernoff, Miriam C.; Mitchell, Charles D.; Seage, George R.; Zilleruelo, Gaston; Abitbol, Carolyn; Andiman, Warren A.; Kaiser, Kathleen A.; Spiegel, Hans; Oleske, James M.

In: Pediatric Nephrology, Vol. 27, No. 6, 01.06.2012, p. 981-989.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chronic kidney disease associated with perinatal HIV infection in children and adolescents

AU - Purswani, Murli U.

AU - Chernoff, Miriam C.

AU - Mitchell, Charles D.

AU - Seage, George R.

AU - Zilleruelo, Gaston

AU - Abitbol, Carolyn

AU - Andiman, Warren A.

AU - Kaiser, Kathleen A.

AU - Spiegel, Hans

AU - Oleske, James M.

PY - 2012/6/1

Y1 - 2012/6/1

N2 - 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.

AB - 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.

KW - Biopsy

KW - FSGS

KW - HIV immune complex kidney disease

KW - HIVAN

KW - Proteinuria

KW - Renal

KW - Youth

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Purswani MU, Chernoff MC, Mitchell CD, Seage GR, Zilleruelo G, Abitbol C et al. Chronic kidney disease associated with perinatal HIV infection in children and adolescents. Pediatric Nephrology. 2012 Jun 1;27(6):981-989. https://doi.org/10.1007/s00467-011-2097-1