Lisa Frigati1,2,3, Sana Mahtab4, Peter Nourse4, Patricio Ray5, Sofia Perrazzo5, Takwanisa Machemedze4, Nana-Akua Asafu Agyei4, Mark Cotton6, Landon Myer7,8, Heather Zar4,9,10. 1. Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. frigati@sun.ac.za. 2. Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa. frigati@sun.ac.za. 3. Research Centre for Adolescent and Child Health (REACH) and Medical Research (MRC) Unit on Child and Adolescent Health, Department of Pediatrics and Child Health, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa. frigati@sun.ac.za. 4. Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. 5. Center for Genetic Medicine Research and Division of Nephrology, Children's National Medical Center, and Department of Pediatrics, The George Washington University, Washington DC, WA, USA. 6. Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa. 7. Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. 8. Centre for Infectious Diseases Epidemiology and Research, School of Public Health and Family Medicine, Cape Town, South Africa. 9. Research Centre for Adolescent and Child Health (REACH) and Medical Research (MRC) Unit on Child and Adolescent Health, Department of Pediatrics and Child Health, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa. 10. MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
Abstract
BACKGROUND: Little is known about renal pathology among perinatally HIV-infected children and adolescents in Africa. We assessed the prevalence of risk factors for chronic kidney disease in South African children and adolescents with perinatally acquired HIV-1 (HIV+) on antiretroviral therapy (ART) and HIV-negative children and adolescents. METHODS: HIV+ youth aged 9-14 years, on ART for > 6 months and age-matched HIV-negative children and adolescents were eligible for assessment of proteinuria and microalbuminuria using urine dipstick and Vantage analyser method. Blood pressure, estimated glomerular filtration rate, HIV-related variables and metabolic co-morbidities were assessed at enrolment. RESULTS: Among 620 children and adolescents, 511 were HIV+. The median age was 12.0 years and 50% were female. In HIV+ children and adolescents, 425 (83.2%) had a CD4 count > 500 cells/mm3 and 391 (76.7%) had an undetectable viral load. The median duration of ART was 7.6 years (IQR 4.6-9.3) with 7 adolescents receiving Tenofovir. The prevalence of any proteinuria, microalbuminuria and hypertension was 6.6%, 8.5% and 13.9%, respectively, with no difference between HIV+ and negative children and adolescents. All participants had a normal glomerular filtration rate. There was no association between metabolic co-morbidities and microalbuminuria. CONCLUSIONS: Proteinuria and microalbuminuria appear to be uncommon in this population. Follow up of those with microalbuminuria may inform long-term outcomes and management of this growing population of HIV+ youth.
BACKGROUND: Little is known about renal pathology among perinatally HIV-infectedchildren and adolescents in Africa. We assessed the prevalence of risk factors for chronic kidney disease in South African children and adolescents with perinatally acquired HIV-1 (HIV+) on antiretroviral therapy (ART) and HIV-negative children and adolescents. METHODS:HIV+ youth aged 9-14 years, on ART for > 6 months and age-matched HIV-negative children and adolescents were eligible for assessment of proteinuria and microalbuminuria using urine dipstick and Vantage analyser method. Blood pressure, estimated glomerular filtration rate, HIV-related variables and metabolic co-morbidities were assessed at enrolment. RESULTS: Among 620 children and adolescents, 511 were HIV+. The median age was 12.0 years and 50% were female. In HIV+ children and adolescents, 425 (83.2%) had a CD4 count > 500 cells/mm3 and 391 (76.7%) had an undetectable viral load. The median duration of ART was 7.6 years (IQR 4.6-9.3) with 7 adolescents receiving Tenofovir. The prevalence of any proteinuria, microalbuminuria and hypertension was 6.6%, 8.5% and 13.9%, respectively, with no difference between HIV+ and negative children and adolescents. All participants had a normal glomerular filtration rate. There was no association between metabolic co-morbidities and microalbuminuria. CONCLUSIONS:Proteinuria and microalbuminuria appear to be uncommon in this population. Follow up of those with microalbuminuria may inform long-term outcomes and management of this growing population of HIV+ youth.
Entities:
Keywords:
Adolescents; Children; HIV; Microalbuminuria; Perinatal; South Africa
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