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REVIEW ARTICLE
Year : 2006  |  Volume : 9  |  Issue : 2  |  Page : 33-41

Human immunodeficiency virus nephropathy in children- A review


Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria

Correspondence Address:
O M lbadin
Department of Child Health, University of Benin Teaching Hospital, Benin City
Nigeria
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Background: Human immunodeficiency virus associated nephropathy (HIVAN ), was first introduced into the medical lexicon in late 1980s following the advent of HIV/AI DS . Initially thought to be peculiar to homosexuals with HIV/AIDS, it Is now known to be a com plication of HIV-1/AID.S. Objectives : To review the subject within the context of rapidly expanding literature but with emphasis on children thus drawing attention to the budding subjects. Review: The prevalence of HIVAN varies from 5-85% amongst HIVIAI DS cohorts but majority of these are in adult males drawn largely from black/Hispanic populations. HIVAN is less frequent and less fulminant in children as compared to adults. Its rate of progression to End Stage Renal Disease (ESRD) Is slower in children who commonly have varied histological pattern other than focal segmental glomerulonephrosis (FSGS) that is typical of adult type. HIVAN is characterized by massive proteinuria, azotaemia, normal blood pressure, normal to large echogenic kidneys resulting from microcyst formation and typical histologic pattern(s). The most frequent clinical expression is nephrotic syndrome, which readily progresses to ESRD. The current pandemic of HIV!AIDS worldwide would tend to suggest a parallel increase in prevalence of HIVAN . Currently it accounts for about 10% of adult cases of ESRD in the United States of America. Conclusions: HIVAN complicates mainly HIV-1 infection. In West Africa, however , substantial cases of HIV/AIDS are due to HIV -2. It remains to be seen how the AIDS pandemic and undue representation of HIV-2 as co-founding factors would affect the prevalence of HIVAN in children. Such issues and others bothering on treatment options, prognosis and histological pattern In the emerging childhood HIV /AIDS in Nigeria are discussed.


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