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Proteinuria in children infected with the human immunodeficiency virus

Aida I Chaparro1, Charles D Mitchell, Carolyn L Abitbol

  • 1Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, University of Miami, Miami, FL, USA.

The Journal of Pediatrics
|May 22, 2008
PubMed

Insights

Proteinuria affects one-third of children with human immunodeficiency virus (HIV). Effective viral load control through antiretroviral therapy improves kidney outcomes and survival rates in these children.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Proteinuria is a significant complication in children with human immunodeficiency virus (HIV).
  • Longitudinal data on proteinuria progression in pediatric HIV cohorts are limited.
  • Understanding renal disease progression is crucial for managing HIV-infected children.

Purpose of the Study:

  • To determine the prevalence of proteinuria in a large cohort of children with HIV.
  • To analyze the longitudinal progression of proteinuria during highly active antiretroviral therapy (HAART).
  • To assess the impact of proteinuria on kidney function, mortality, and survival rates.

Main Methods:

  • Retrospective cohort study of 286 children with HIV.
  • Quantitative proteinuria assessment using urine protein to creatinine ratio (Upr/cr).
  • Monitoring of viral load, lymphocyte profiles, kidney function, and mortality rates over an average of 5.6 years.

Main Results:

  • 33% of children had proteinuria at baseline; 11.2% had nephrotic range proteinuria.
  • Mortality rates were significantly higher in children with proteinuria.
  • Improvement in proteinuria correlated with decreased viral load (r = 0.5; P < .01).

Conclusions:

  • Controlling viral load with HAART appears to prevent the progression of HIV-associated renal disease.
  • Effective HAART is associated with improved survival rates in HIV-infected children with proteinuria.
  • Early detection and management of proteinuria are vital for pediatric HIV care.
Abstract

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