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Screening for osteo-renal involvement in the Romanian HIV cohort

Background

When assessing comorbidities in HIV-infected patients, the bone and the kidney represent important target organs that can potentially be affected by both virus and antivirals. Given the particular characteristics of the Romanian HIV cohort [1], most of the patients have experienced HIV infection in childhood and have received multiple therapeutic regimens since the advent of antiretroviral (ARV) therapy. Thus, the need to screen for osteo-renal impairment in these patients is high on the priority list [2].

Methods

We have started a project to evaluate key markers of kidney disease and assess the risk for fracture and kidney involvement in the Romanian cohort of HIV-infected patients.

Results

To date, 645 subjects have been enrolled, the group being representative for the whole country, being monitored in all the 9 regional HIV/AIDS reference centers in Romania. We present the descriptive data for this group of patients.

The mean age was 24.3±2.4 years, with a median age at HIV diagnosis of 11 years old. The main transmission route for HIV infection was parenteral (75.35%). Vertical transmission accounted for 1.4% of cases, heterosexual contact for 6.05%, homosexual contact for 0.61% and in 16.59% of cases the transmission route could not be ascertained.

The current median CD4 cell count was 488 cells/cmm, with a median nadir CD4 cell count of 110 cells/cmm. Most of the patients had received multiple ARV regimens over time: 50.85% over 3 regimens, 47.13% 1-3 regimens, and only 2.02% were ARV-naïve.

Conclusion

In the following months we plan to complete the osteo-renal evaluation for the patients with the characteristics described above, and to develop a clinical algorithm for predicting, diagnosing and monitoring bone and kidney involvement in patients with chronic viral infections.

References

  1. 1.

    Wanless RSB, Rugină S, Ruță SM, Dumitru IM, Cernat RC, Schwarzwald HL, Calles NR, Schutze GE, Schweitzer AM, Draper HR, Kline MW: Nine-year follow-up of HIV-infected Romanian children and adolescents receiving lopinavir/ritonavir-containing highly active antiretroviral therapy. GERMS. 2013, 3 (3): 90-95. 10.11599/germs.2013.1042.

  2. 2.

    Streinu-Cercel A: Osteo-renal impairment in HIV infection. GERMS. 2014, 4 (2): 29-10.11599/germs.2014.1052.

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Acknowledgements

1) This paper is partially supported by the Osteo Renal Program, AbbVie.

2) This paper is partially supported by the Sectoral Operational Programme Human Resources Development (SOP HRD), financed from the European Social Fund and by the Romanian Government under the contract numbers POSDRU/159/1.5/S/137390.

Author information

Correspondence to Anca Streinu-Cercel.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Keywords

  • Transmission Route
  • Priority List
  • Chronic Viral Infection
  • Heterosexual Contact
  • Main Transmission