HIV ASSOCIATED NEPHROPATHY IN CHILDREN

儿童 HIV 相关肾病

• 批准号: 3241319
• 负责人: JOSE STRAUSS
• 金额: $ 29.9万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-02-01 至 1994-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3241319
• 关键词: HIV infections; child (0-11); glomerular filtration rate; hematuria; histopathology; human immunodeficiency virus 1; human subject; immunopathology diagnosis; kidney disorder diagnosis; nephrosis; nervous system disorder; neurologic manifestations; pediatric AIDS; proteinuria; radionuclide imaging /scanning; urinalysis; virus infection mechanism

Since 1981 15 cases of renal disease have been identified in children infected with the Human Immunodeficiency Virus (HIV) in Miami. This number represents approximately 8% of the total population of children with HIV infection that is currently being followed at the University of Miami. Most of these children initially presented with proteinuria and nephrosis. Histologically these cases are associated with a diverse array of findings including focal segmental sclerosis (FSS), diffuse or focal mesangial hyperplasia (MH), minimal change (MC), SLE-like changes ("SLE") and tubulo-interstitial nephropathy (TIN). We propose to begin a prospective case controlled study of the HIV-associated nephropathy in children perinatally infected with HIV. All infants born at the University of Miami/Jackson Memorial Medical Center (UM/JMH) and who are HIV-infected will be included in the study and prospectively followed from the day of birth to document development of the nephropathy. It will be required that infants be born at UM/JMH and that they have no other type of gross birth defect identified. Each infant enrolled will be seen every three months and have a urine Labstix (registered trademark) for screening; those with abnormal findings will be studied (as indicated) by urinalysis, CBC, serum electrolytes and creatinine, renal ultrasound, urine culture, renal scan, voiding cystourethrogram, renal tubular function evaluation, degree of proteinuria, serological tests, glomerular filtration rate, effective renal blood flow, and filtration fraction. Those patients with persistent abnormal proteinuria or hematuria, increased kidney size or echogenicity, or decreased GFR will have a Gallium scan and a renal biopsy. An attempt will be made to elucidate the pathogenesis of the HIV associated nephropathy by performing antigen-antibody elution experiments, using molecular probes to detect viral protein expression in renal parenchyma, and assessing tissue infiltrating lymphocytes, inflammatory cells, HIV receptors, and ultrastructural markers. An effort will also be made to identify certain clinical indicators which can predict the development of, or correlate with the severity of, the renal disease.

自 1981 年以来，已发现 15 例肾病病例 感染人类免疫缺陷病毒（HIV）的儿童 迈阿密。 这个数字约占总数的8% 目前正在接受艾滋病毒感染的儿童人数 其次是迈阿密大学。 这些孩子大多数 最初表现为蛋白尿和肾病。 组织学上 这些案例与一系列不同的调查结果相关 包括局灶性节段性硬化症 (FSS)、弥漫性或局灶性 系膜增生 (MH)、微小病变 (MC)、SLE 样病变 （“SLE”）和肾小管间质性肾病（TIN）。 我们建议 开始对 HIV 相关的前瞻性病例对照研究 围产期感染艾滋病毒的儿童肾病。 所有婴儿 出生于迈阿密大学/杰克逊纪念医学中心 （UM/JMH）和 HIV 感染者将被纳入研究 并从出生之日起进行前瞻性跟踪以记录 肾病的发展。 婴儿将被要求 在 UM/JMH 出生，并且没有其他类型的总出生 已识别出缺陷。 每三个登记的婴儿将会被看到一次 几个月并有尿液 Labstix（注册商标） 筛查；那些有异常发现的人将被研究（如 表明）通过尿液分析、CBC、血清电解质和肌酐， 肾脏超声、尿培养、肾脏扫描、排尿 膀胱尿道造影、肾小管功能评估、程度 蛋白尿、血清学检查、肾小球滤过率、 有效肾血流量和滤过分数。 那些 持续出现异常蛋白尿或血尿的患者， 肾脏大小或回声性增加，或 GFR 降低将导致 镓扫描和肾活检。 将尝试 阐明 HIV 相关肾病的发病机制 进行抗原抗体洗脱实验，使用分子 检测肾实质中病毒蛋白表达的探针，以及 评估组织浸润淋巴细胞、炎症细胞、HIV 受体和超微结构标记。 也将努力 旨在确定某些可以预测病情的临床指标 肾病的发展或与肾病的严重程度相关 疾病。