Microalbuminuria in Perinatally HIV-Infected Children and Adolescents in the United States

BACKGROUND: The kidney is a common target for human immunodeficiency virus (HIV), making renal disease a common noninfectious complication of HIV. Microalbuminuria is an important marker that can detect early renal damage. Timely detection of microalbuminuria is important to initiate renal management and stop the progression of renal dysfunction in people with HIV. Limited data are available about renal abnormalities in people with perinatal HIV infection. The objective of this study was to determine the prevalence of microalbuminuria in a cohort of perinatally HIV-infected children and young adults receiving combination antiretroviral therapy and investigate correlations between microalbuminuria and clinical and laboratory findings. METHODS: This was a retrospective study of 71 patients with HIV followed in an urban pediatric HIV clinic in Houston, Texas, between October 2007 and August 2016. Demographic, clinical, and laboratory data were compared between subjects with persistent microalbuminuria (PM) and those without. PM is defined as a microalbumin-to-creatinine ratio ≥30 mg/g on at least 2 occasions separated by at least 1 month. RESULTS: Sixteen of 71 patients (23%) met the definition of PM. In univariate analysis, patients with PM had significantly higher CD8(+) T-cell activation and lower CD4(+) T-cell nadir. Multivariate analysis demonstrated increased microalbuminuria to be independently associated with older age and CD8(+) T-cell activation measured as CD8(+)HLA-DR(+) T-cell percentage. CONCLUSIONS: Older age and increased activation of CD8(+)HLA-DR(+) on T cells correlate with presence of microalbuminuria in this cohort of HIV-infected patients.