Renal dysfunction in a small cohort of perinatally infected HIV-1 patients

Background
Chronic kidney disease is an important health concern in HIV-positive individuals. Renal affection can be due to HIV infection itself and or effects of some antiretroviral medications mainly tenofovir (TDF). Among renal abnormalities in HIV patients, microalbuminuria is an important marker that is used as screening tool for kidney injury in HIV patients. 
Methods:
A retrospective analysis was performed on a cohort of HIV positive children from 2007 to 2015 at an urban pediatric HIV clinic. Patients were included if they acquired HIV perinatally, had at least 2 microalbumin: creatinine ratio (M:C) measurements separated by at least 1 month during the study period, and complete demographic, clinical and laboratory data. 

Results
Among 77 perinatally HIV-infected patients, 70 met the rest of the inclusion criteria for the study. 16/69 patients (23%) met preset definition for microalbuminuria (2 or more M:C measurements separated by at least 1 month that are above 30 mg/g). Demographics and laboratory outcomes and TDF exposure for the microalbuminuria group (16 patients) were compared to those of the 53 patients who did not meet the definition of microalbuminuria.

Conclusions:
Our study shows significant prevalence of microalbuminuria (23%) in perinatally HIV-infected patients. The microalbuminuria group exhibits marked activation of CD8+, higher cumulative VL and lower CD4% nadir during the study period. In our small cohort, TDF exposure did not seem be a major factor contributing to microalbuminuria indicating the possibility of multifactorial mechanism of microalbuminuria in this patient population.

RENAL DYSFUNCTION IN A SMALL COHORT OF PERINATALLY INFECTED HIV-1 PATIENTS