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nephropathy in hiv childrens

Karalanglin Tiewsoh, Ankur Kumar Jindal, Dhrubajyoti Sharma, Sunil Arora, Ranjana W Minz, Parimal Agrawal, Ritambhra Nada, Deepti Suri
There is a paucity of literature on renal diseases associated with HIV infection in Asian countries. Renal disease in HIV-infected children can involve the glomerulus, interstitium, tubules or blood vessels of the kidney. In this case series, five HIV-infected children with various forms of renal disease are reported. The renal pathology included HIV-associated nephropathy, collapsing focal segmental glomerulosclerosis without tubular changes, tubule-interstitial nephritis and minimal change disease (MCD). Case five fulfilled the classification criteria for childhood polyarteritis nodosa (PAN)...
May 4, 2018: Paediatrics and International Child Health
Wasiu A Olowu, Adebowale Ademola, Adebukola B Ajite, Yauba M Saad
This descriptive and comparative review examines the changing epidemiology, treatment, renal and patient outcome of childhood nephrotic syndrome (NS) in tropical Africa (TpAfr). In the 1960s to 1980s, corticosteroid-resistant non-minimal change disease (nMCD) including quartan malaria nephropathy (QMN) was the dominant renal histopathology type. The overall incidence of NS was 0.35-1.34% of hospital admissions. Median age at onset of NS ranged between 4.0 and 12.0 years while the mean (SD) age range was 5.8 (3...
November 2017: Paediatrics and International Child Health
Ankur Kumar Jindal, Karalanglin Tiewsoh, Rakesh Kumar Pilania
Human immunodeficiency virus (HIV) infection continues to be a leading cause of morbidity and mortality. HIV-infected individuals are now surviving for a relatively longer period and this is because of easy accessibility to antiretroviral therapy these days. As a result, chronic disease-related complications are now being recognized more often. Kidney disease in HIV-infected children can vary from glomerular to tubular-interstitial involvement. We searched the database to identify various kidney diseases seen in HIV-infected children...
January 2018: Infectious Diseases
Ayah Elmaghrabi, Elizabeth Brown, Ei Khin, Jared Hassler, Allen R Hendricks
Tubuloreticular inclusions (TRIs) are subcellular structures located within the cisternae of endoplasmic reticulum. Formation of TRIs has been linked to the exposure of excess interferon (IFN), either from endogenous or exogenous sources. In renal disease, TRIs have been most commonly associated with systemic lupus erythematosus (SLE), and human immunodeficiency virus-associated nephropathy (HIVAN). Case reports of patients with renal biopsies showing TRIs without underlying SLE or HIV are infrequent in adults, and to our knowledge none have been reported in children...
May 2017: Case Reports in Nephrology and Dialysis
Jinliang Li, Jharna R Das, Pingtao Tang, Zhe Han, Jyoti K Jaiswal, Patricio E Ray
Studies have shown that podocytes and renal tubular epithelial cells from patients with HIV-associated nephropathy (HIVAN) express HIV-1 transcripts, suggesting that productive infection of renal epithelial cells precipitates development of HIVAN. However, podocytes and renal tubular epithelial cells do not express CD4 receptors, and it is unclear how these cells become productively infected in vivo We investigated the mechanisms underlying the infection by HIV-1 of podocytes cultured from the urine of children with HIVAN...
March 2017: Journal of the American Society of Nephrology: JASN
Murli U Purswani, Kunjal Patel, Cheryl A Winkler, Stephen A Spector, Rohan Hazra, George R Seage, Lynne Mofenson, Brad Karalius, Gwendolyn B Scott, Russell B Van Dyke, Jeffrey B Kopp
APOL1 renal risk alleles are associated with chronic kidney disease (CKD) in adults, with the strongest effect being for HIV-associated nephropathy. Their role in youth with perinatal HIV-1 infection (PHIV) has not been studied. In a nested case-control study of 451 PHIV participants in the Pediatric HIV/AIDS Cohort Study, we found a 3.5-fold increased odds of CKD in those carrying high-risk APOL1 genotypes using a recessive model [95% confidence interval (CI): 1.2 to 10.0]. We report an unadjusted incidence of 1...
September 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Xuefang Xie, Anamaris M Colberg-Poley, Jharna R Das, Jinliang Li, Aiping Zhang, Pingtao Tang, Marina Jerebtsova, J Silvio Gutkind, Patricio E Ray
Podocyte injury has a critical role in the pathogenesis of HIV-associated nephropathy (HIVAN). The HIV-1 transactivator of transcription (Tat), combined with fibroblast growth factor-2 (FGF-2), can induce the dedifferentiation and proliferation of cultured human podocytes. Cellular internalization of Tat requires interactions with heparan sulfate proteoglycans and cholesterol-enriched lipid rafts (LRs). However, the specific distribution of Tat in human podocytes and its ability to associate with LRs have not been documented...
August 2014: Journal of the American Society of Nephrology: JASN
Javier Loricera, Vanesa Calvo-Río, Cristina Mata, Francisco Ortiz-Sanjuán, Marcos A González-López, Lino Alvarez, M Carmen González-Vela, Susana Armesto, Héctor Fernández-Llaca, Javier Rueda-Gotor, Miguel A González-Gay, Ricardo Blanco
Urticarial vasculitis (UV) is a subset of cutaneous vasculitis (CV), characterized clinically by urticarial skin lesions of more than 24 hours' duration and histologically by leukocytoclastic vasculitis. We assessed the frequency, clinical features, treatment, and outcome of a series of patients with UV. We conducted a retrospective study of patients with UV included in a large series of unselected patients with CV from a university hospital. Of 766 patients with CV, UV was diagnosed in 21 (2.7%; 9 male and 12 female patients; median age, 35 yr; range, 1-78 yr; interquartile range, 5-54 yr)...
January 2014: Medicine (Baltimore)
A D Ademola, O O Asinobi, R E Oladokun, O O Ogunkunle, C A Okoloz, G E Ogbole
BACKGROUND: There is a paucity of data on the clinicopathologic pattern of kidney disease in human immunodeficiency virus (HIV) seropositive children from sub-Saharan Africa and non from south west Nigeria. OBJECTIVE: To determine the clinical pattern and outcome of kidney disease among HIV positive children hospitalised at a tertiary hospital South West Nigeria METHODOLOGY: A retrospective study of all HIV positive children who were hospitalised and managed for kidney diseases over a period of 78 months at the University College Hospital Ibadan, South West Nigeria...
June 2012: African Journal of Medicine and Medical Sciences
Ezeonwu Bertilla Uzoma, Okafor Henrietta Uchenna, Ikefuna Anthony Nnaemeka, Oguonu Tagbo
Background. Human immunodeficiency virus associated nephropathy (HIVAN) is a rapidly progressive chronic renal parenchymal disease that occurs in HIV-infected individuals and manifests commonly as proteinuria, which is preceded by microalbuminuria (MA). This clinical entity is defined as a spot urine albumin of 20-200 mg/L. Objectives. To determine the prevalence of microalbuminuria in HIV positive children in UNTH, Enugu and compare it with that of HIV-negative children. Methods. A total of 154 HIV positive children aged 18 months to 14 years and 154 HIV-negative children of corresponding attributes were screened for microalbuminuria, using Micral test II strip which has a sensitivity of 90-99%...
2012: International Journal of Nephrology
Duran Ramsuran, Rajendra Bhimma, Pratistadevi K Ramdial, Elaene Naicker, Miriam Adhikari, Julian Deonarain, Yetish Sing, Thajasvarie Naicker
BACKGROUND: Despite the burden of human immunodeficiency virus (HIV) disease in Southern Africa, there have been few reports of HIV-related nephropathy in children. This study outlines the spectrum of HIV-1-related kidney diseases of children in KwaZulu-Natal, South Africa. METHODS: A review of the clinical presentation, laboratory and histopathological findings of children diagnosed with HIV-related nephropathy. RESULTS: Forty-nine out of 71 children (1-16 years old) with HIV-1 related nephropathy underwent kidney biopsy...
May 2012: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Shivaram Hegde, Cheentan Singh, Bernadette Ohare
Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) is most frequently seen as a late manifestation in adult patients with a high viral load and low T-helper cell (CD4) counts. We report a case of HIVAN in a black Zimbabwean teenager in whom the disease activity was well suppressed for years following highly active antiretroviral therapy (HAART). Proteinuria was absent at 9 years of age when he presented with vertically transmitted HIV infection. Within a few months of HAART, the viral load became undetectable and CD4 count was normalised...
June 2011: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
F U Eke, I C Anochie, A N Okpere, A U Eneh, R O Ugwu, R N Ugwu, A A Ejilemele, H U Ugboma
BACKGROUND: Microalbuminuria is an early manifestation of HIV associated nephropathy (HIVAN). This study was to determine the prevalence and risk factors for microalbuminuria in children with HIV infection in Port Harcourt, Nigeria. METHODS: Urine specimen of 50 children with HIV infection seen over a 4 months period (October 2007-February 2008) was assayed for albumin and creatinine to determine urinary albumin to creatinine ratio (ACR). Microalbuminuria was defined as urinary albumin to creatinine ratio (ACR) of greater than 2...
July 2010: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
Pratistadevi K Ramdial, Yetish Sing, Julian Deonarain, Rajendra Bhimma, Nivesh Chotey, Vikash Sewram
Pediatric cryptococcosis has been documented in various organs, but pediatric renal cryptococcosis (RC) remains undocumented to date. The authors report RC in 2 children with AIDS, 7 and 9 years of age, with proteinuria. Both patients, on antiretroviral therapy (ARV) for 28 (patient 1) and 54 (patient 2) weeks each, had secured viral immunosuppression, but immune restoration was realized by patient 1 only. Cryptococcal immune reconstitution inflammatory syndrome (IRIS) was diagnosed on the renal biopsy from patient 1 based on the clinicopathological profile and the presence of segmental glomerular and an interstitial lymphoplasmacytic and granulomatous reaction to Cryptococcus neoformans, with a predominance of capsule-deficient fungal forms...
June 2011: International Journal of Surgical Pathology
Warren A Andiman, Miriam C Chernoff, Charles Mitchell, Murli Purswani, James Oleske, Paige L Williams, Hans Spiegel, Phil Gona, George R Seage
BACKGROUND: Survival of HIV-infected children continues to increase and the use of antiretrovirals (ARVs) is expanding; however there are few data regarding the incidence of renal dysfunction and associated risk factors among HIV-infected children and youth. METHODS: A total of 2102 children enrolled in Pediatric AIDS Clinical Trials Group Study 219/219C, were followed and assessed prospectively for >30 months. Occurrence of clinical events and laboratory abnormalities were recorded using standardized criteria and forms...
July 2009: Pediatric Infectious Disease Journal
Angel A Soler-García, Natella Y Rakhmanina, Parnell C Mattison, Patricio E Ray
Human immunodeficiency virus (HIV)-infected children are at risk of developing several types of renal diseases, including HIV-associated nephropathy (HIVAN), which is usually seen during late stages of infection in children with a high viral load. This disease is defined by the presence of proteinuria associated with mesangial hyperplasia and/or global-focal segmental glomerulosclerosis combined with microcystic transformation of the renal tubules. Because HIVAN can have an insidious clinical onset, renal biopsy is the only definitive way of establishing a diagnosis...
July 2009: Kidney International
Patricio E Ray
Childhood human immunodeficiency virus-associated nephropathy (HIVAN) is defined by the presence of proteinuria associated with mesangial hyperplasia and/or global-focal segmental glomerulosclerosis, in combination with the microcystic transformation of renal tubules. This review discusses the pathogenesis of childhood HIVAN and explores how the current pathological paradigm for HIVAN in adults can be applied to children. The Human Immunodeficiency Virus-1 (HIV-1) induces renal epithelial injury in African American children with a genetic susceptibility to develop HIVAN...
November 2009: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Pierre Cochat, Sonia Fargue, Guillaume Mestrallet, Therese Jungraithmayr, Paulo Koch-Nogueira, Bruno Ranchin, Lothar Bernd Zimmerhackl
Renal transplantation (Tx) is the treatment of choice for end-stage renal disease. The incidence of acute rejection after renal Tx has decreased because of improving early immunosuppression, but the risk of disease recurrence (DR) is becoming relatively high, with a greater prevalence in children than in adults, thereby increasing patient morbidity, graft loss (GL) and, sometimes, mortality rate. The current overall graft loss to DR is 7-8%, mainly due to primary glomerulonephritis (70-80%) and inherited metabolic diseases...
November 2009: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Roberto Gordillo, Juhi Kumar, Marcela Del Rio, Joseph T Flynn, Robert P Woroniecki
Human immunodeficiency virus (HIV) infection accounts for an unknown percentage of children with end-stage kidney disease (ESKD). Our objective was to compare the outcome of renal replacement therapy (RRT) in subjects with ESKD due to HIV and other diagnoses and to examine the prevalence of ESKD due to HIV. We analyzed Kt/V, morbidity, mortality, echocardiography, nutritional, and transplant status in 12 dialysis patients with HIV and 32 without HIV followed at our center between February 2002 and February 2007...
January 2009: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Aida I Chaparro, Charles D Mitchell, Carolyn L Abitbol, James D Wilkinson, Giovanna Baldarrago, Erika Lopez, Gastón Zilleruelo
OBJECTIVES: To determine the prevalence of proteinuria in a large cohort of children infected with the human immunodeficiency virus (HIV) and their longitudinal progression during treatment with highly active antiretroviral therapy. STUDY DESIGN: In a retrospective cohort study, 286 children infected with HIV were monitored with quantitative assays of proteinuria from January 1998 through January 2007, with monitoring of viral load, lymphocyte profiles, kidney function, and mortality rates...
June 2008: Journal of Pediatrics
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