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Abstract: FR-PO1093

Renal Abnormalities in HIV-Exposed Children: A Guatemalan Retrospective Cohort Study

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Lizama, Guerthy S., Roosevelt Hospital, Guatemala, Guatemala
  • Juarez, Julio W., Roosevelt Hospital, Guatemala, Guatemala
  • Aguilar, Angie Lizet, FUNDANIER, Guatemala, Guatemala
  • Lou-Meda, Randall M., Fundanier, Guatemala, Guatemala
Background

Among the various organs involved with the progression of HIV infection, the kidneys have had a significant impact
Studies have highlighted the importance of early detection of kidney disease in HIV-infected patients in order to reduce the progression of CKD
We identify the renal abnormalities in HIVexposed children in a tertiary hospital in Guatemala

Methods

After ethics approval, we retrospectively evaluated a cohort of patients perinatally exposed to HIV during the period 2015-2016
Patients attending the outpatient clinic for at least 6 months were captured in the study. eGFR, pr/cr, ca/cr ratio were obtained at the time of inclusion and at least 6 months after enrollment. Renal abnormality was outlined if lasting more than 6 months
Clinical and immunologic status, viral load, time in which the patient was without antiretroviral treatment since HIV perinatal exposure and time of antiretroviral exposure were determined

Results

From 102 patients enrolled, 52 were HIV positive and 50 were HIV negative. The mean age was 12.2yr(SD, 4.9) and 40% of the patients were male. 56%(29/52) of the infected patients had a C clinical status, 62%(32/52) had a severe immunosuppression status and 39%(20/52) had a viral load<50 thousand
The mean pretreatment time was 2.82yr(SD, 2.5) and the mean time of antiretroviral exposure was 8yr(SD,3). Regarding renal function marker, 42%(22/52) of the infected patients had an eGFR abnormality (20 patients had eGFR>140 and 2 patients had eGFR<90ml/min/1.73m2), compared to 10%(5/50) of the uninfected patients (all the patients had eGFR>140ml/min/1.73m2). Infected patients had 4 times higher risk to present abnormalities in eGFR compared to uninfected patients.IC-95%(1.73-10.30)
The mean eGFR values at 0-2, 2-4, 4-6 and >6yr of pretreatment time were 177.73(SD,91.12), 171.59(SD,91.12) and 171.27ml/min/1.73m2(SD,94.16).The 0-2yr of pretreatment time group had the highest frequency of abnormalities in eGFR and pr/cr ratio, compared to the rest of the groups. 48%(25/52) of the patients during the antiretroviral exposure, 50%(26/52) with C clinical status, 52%(27/52) with 3 immunologic status and 21%(11/52) with ≤50thousand load had at least 1 renal abnormality

Conclusion

Hyperfiltration was the predominant renal abnormality in HIV infected patients
The early screening for renal function is mandatory in all HIV exposed patients