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World J Clin Cases. Apr 16, 2013; 1(1): 13-18
Published online Apr 16, 2013. doi: 10.12998/wjcc.v1.i1.13
Proteinuria in paediatric patients with human immunodeficiency virus infection
Vania Giacomet, Paola Erba, Francesca Di Nello, Sonia Coletto, Alessandra Viganò, GianVincenzo Zuccotti
Vania Giacomet, Paola Erba, Francesca Di Nello, Sonia Coletto, Alessandra Viganò, GianVincenzo Zuccotti, Department of Paediatrics, L Sacco Hospital, University of Milan, 20157 Milan, Italy
Author contributions: Giacomet V and Erba P wrote the review; Di Nello F and Coletto S revised the literature; Viganò A and Zuccotti G revised the review.
Correspondence to: Vania Giacomet, MD, Department of Paediatrics, L Sacco Hospital, University of Milan, Via GB Grassi 74, 20157 Milan, Italy. giacomet.vania@hsacco.it
Telephone: +39-23-9042265 Fax: +39-23-9042254
Received: November 13, 2012
Revised: January 18, 2013
Accepted: March 15, 2013
Published online: April 16, 2013
Abstract

In human immunodeficiency virus (HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specific clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for long-term use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological findings related to kidney disease in HIV-infected children and adolescents.

Keywords: Human immunodeficiency virus-infection, Nephropathy, Proteinuria, Antiretroviral therapy, Children

Core tip: Higly active antiretroviral therapy has decreased the mortality and morbidity of human immunodeficiency virus (HIV)-infected adults and children, too. Many of the antiviral drug used can cause side effects and in particular renal toxicity. A monitoring of renal function is useful for the management of HIV-infected patients.