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).