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1994-10-25
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Document 2631
DOCN M94A2631
TI Antiretroviral therapy in HIV infected children with proteinuria.
DT 9412
AU Binda Ki Muaka P; Mbensa Massabi L; Departement de Pediatrie, Cliniques
Universitaires, Kinshasa,; Zaire.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):260 (abstract no. PB0471). Unique
Identifier : AIDSLINE ICA10/94369944
AB OBJECTIVE: HIV associated nephropathy (HIVAN) is now considered as a
distinct clinicopathologic entity. Mesangial hyperplasia,
membrano-proliferative glomerulonephritis and focal-segmental
glomeruloselerosis are the predominant histological glomerular lesions.
HIVAN is clinically manifested as heavy proteinuria and progressive
renal insufficiency. METHODS: Since January 1992, all infected children
followed in our Department for massive proteinuria are treated with an
antiviral (Retrovir) as soon as the diagnosis was made at least on two
plasma samples cell culture positive for HIV according to the CDC
criterias (1989). Renal fonction (azotemia, proteinuria, glomerular
filtration rate) was regularly checked every three months. The per oral
daily dosis was reduced at 50 mg/m2 three times in order to prevent side
effects generally recognized to this drug. RESULTS: Six children aged
about 82 months on average (range 36-126 months) have been studied (2
girls and 4 boys). Two patients were symptomatic with regular
respiratory tract infections. The other children were asymptomatic but
with heavy proteinuria (50 mg/kg/day) and falling of glomerular
filtration rate (GFR) around 55 ml/min/1.73 m2 (range 50-65). Between 6
and 12 months, mean GFR was 85 ml/min/1.73 m2 (range 79-90; after 18
months, mean GFR was 105 ml/min/1.73 m2 (range 100-116). Meanwhile, all
dispsticks became negative for proteinuria and hematuria. DISCUSSION AND
CONCLUSION: During the study, we have observed a reducing of frequency
of clinical manifestations and a progressive improvement of the renal
function. In spite of the small sample, we rise the question of an
eventual role of an early antiretroviral therapy in HIVAN.
DE Child Child, Preschool Dose-Response Relationship, Drug Drug
Administration Schedule Female Glomerular Filtration Rate/DRUG EFFECTS
Glomerulonephritis/*DRUG THERAPY Human HIV Infections/*DRUG THERAPY
Kidney Function Tests Male Proteinuria/*DRUG THERAPY
Zidovudine/ADVERSE EFFECTS/*THERAPEUTIC USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).