Leroy B, Pressac M, Bensman A, Sinnassamy P, Courpotin C; International Conference on AIDS.
Int Conf AIDS. 1992 Jul 19-24; 8: B232 (abstract no. PoB 3850).
Hopital Armand Trousseau, Paris, France.
HIV nephropathy (HIVN) is now considered as a distinct clinicopathologic entity, and evidence points currently to a direct implication of the HIV in HIVN. Proteinuria and azotemia are the more frequent biological symptoms, and mesangial hyperplasia, focal and segmental glomerulosclerosis the predominant histological glomerular lesions. Incidence of HIVN, defined by biological markers, has been reported to reach 57% in perinatally infected children (CHANDER et al. Kidney int 1989). As since June 1987 all of the perinatally infected children followed in our institution are treated with antiretroviral agents as soon as the diagnosis is made--ie at least two plasma mononuclear cells culture positive for HIV-, the study of the incidence of HIVN in this population is of particular interest. We prospectively screened outpatient symptomatic (S) and asymptomatic (A) non febrile perinatally HIV infected children for biological markers of glomerular abnormality, BUN and plasma creatinine (PCr) were measured in a discrete analyser (RAXT, Technicon); microalbuminuria was measured by nephelometry on a single morning urine sample, and results were expressed using urinary microalbumin (mg)/creatinine (mmol.) ratio (U microA/Cr); GFR was estimated from PCr according to the Schwartz method; hematuria and proteinuria were checked by dipsticks. Results: 27 children aged 44 month on average (range 5-120) have now been studied (59% male, 55% black); 2 children were asymptomatic (A) and 25 were symptomatic (S). Among the S children, 7 had AIDS according to the 1989 CDC criteria, 16 had a CD4/CD8 ratio less than 1., 10 were positive for P24 antigenemia. All the dipsticks were negative for proteinuria and hematuria; mean BUN was 4 mmol/l (range: 1.8-6.5); GFR remained in the normal range for age: before 12 months of age, mean GFR was 55 ml/mn/1.73 m2 (range 50-60); between 12 and 24 months mean GFR was 98 ml/mn/1.73 m2 (range 82-112); after 24 months mean GFR was 115 ml/mn/1.73 m2 (range 88-164); U microA/Cr was upon 3 in 4 patients among which 1 had AIDS. Conclusion: We observed minor biological markers of glomerular abnormality in this studied population of non hospitalized HIV infected children but no nephrotic syndrome nor chronic renal failure was found. Despite these results must be asserted by a larger sample, it raise the question of the role of an early antiretroviral therapy for the prevention of HIV nephropathy.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Child
- Disease Progression
- Glomerular Filtration Rate
- HIV Infections
- HIV Seropositivity
- Hematuria
- Humans
- Incidence
- Kidney
- Kidney Diseases
- Male
- Prospective Studies
- Proteinuria
Other ID:
UI: 102199292
From Meeting Abstracts