Prevalence of risk factors for chronic kidney disease in South African youth with perinatally acquired HIV
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.
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.
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.
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.
KeywordsHIV Perinatal Children Adolescents Microalbuminuria South Africa
The Cape Town Adolescent Antiretroviral Cohort is supported by National Institutes of Health grant R01HD074051 and the South African Medical Research Council. Lisa Frigati is supported by the South African Medical Research Council.
Compliance with ethical standards
Ethical approval was given by the Faculty of Health Sciences, University of Cape Town and Stellenbosch University, Human Research Ethics Committee (051/2013). Parents gave informed consent and assent was taken from all adolescents.
Conflict of interest
The authors declare that they have no conflict of interest.
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