Highlights of Major Differences Between Children and Adults with HIV-Associated Nephropathy

Major differences between human immunodeficiency virus (HIV) associated nephropathy (HIVN) in children and HIVN in adults include the following: HIVN occurs in both HIV-1 + and AIDS adults, but apparently only in AIDS children. In HIVN patients, the virus has been transmitted to adult males mostly by intravenous drug use, and to adult females mostly by intercourse with infected males, but the virus has been transmitted to male and female infants and children by the mother. Renal histology changes in HIVN adults are mostly of the focal and segmental sclerosis (FSS) type, but FSS type changes are found in only one-third-one-half of HIVN children. The onset of chronic renal failure in adults heralds a rapid (few weeks) course to death, but in children the course is much slower (several months). Acute renal failure is rarely diagnosed in HIVN children while it is commonly diagnosed in HIVN adults.