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Longitudinal patterns of kidney function in children with HIV: insights from group-based trajectory modeling
Soumya Tiwari1, Viswas Chhapola1, Srashti Garg2
1Department of Pediatrics.
AIDS (London, England)
|August 6, 2026
Summary
Kidney function in children with HIV (CWH) shows varied patterns. Delayed antiretroviral therapy (ART) initiation and lower CD4 counts are linked to declining kidney function over time.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- HIV/AIDS Research
Background:
- Kidney dysfunction is a growing concern in children living with HIV (CWH).
- Understanding longitudinal kidney function patterns is crucial for managing CWH.
- Previous studies have not fully characterized the diverse trajectories of kidney function in this population.
Purpose of the Study:
- To identify distinct longitudinal patterns of kidney function in a hospital-based cohort of CWH.
- To analyze factors associated with different kidney function trajectories.
Main Methods:
- Retrospective analysis of estimated glomerular filtration rate (eGFR) data up to 12 years post-antiretroviral therapy (ART) initiation.
- Group-based trajectory modeling (GBTM) to identify eGFR trajectories.
- Multinomial logistic regression to assess predictors of trajectory membership.
Main Results:
- Three distinct eGFR trajectories were identified: static (53.5%), early-decline (34.5%), and late-decline (12.0%).
- Proteinuria was more common in both decline trajectories.
- Older age at ART initiation and lower baseline CD4 percentage were independently associated with adverse kidney function trajectories.
Conclusions:
- Heterogeneity in kidney function exists among CWH, as evidenced by distinct eGFR trajectories.
- Delayed ART initiation significantly increases the risk of adverse kidney function.
- Lower baseline CD4 percentage is a key predictor for late-declining kidney function.
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