{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T20:56:48Z","timestamp":1773435408708,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T00:00:00Z","timestamp":1543190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2015\u201003295"],"award-info":[{"award-number":["2015\u201003295"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2019,2]]},"abstract":"Objectives<\/jats:title>The aim of the study was to investigate the prevalence of renal function and liver enzyme abnormalities among HIV<\/jats:styled-content>\u2010infected children, changes in prevalence with time on combination antiretroviral therapy (cART<\/jats:styled-content>), and the factors associated with these abnormalities.<\/jats:p><\/jats:sec>Methods<\/jats:title>A prospective cohort study was conducted among HIV<\/jats:styled-content>\u2010infected children < 18 years old (n<\/jats:italic> = 705) who were on first\u2010line cART<\/jats:styled-content>. Liver enzymes, renal function, haematology, immunology and virological response were assessed at enrolment and followed bi\u2010annually for 18 months. Liver fibrosis and cirrhosis were assessed using noninvasive markers including the aspartate aminotransferase (AST<\/jats:styled-content>) to platelet ratio index (APRI<\/jats:styled-content>) and fibrosis score (FIB<\/jats:styled-content>\u20104).<\/jats:p><\/jats:sec>Results<\/jats:title>The median age was 12 [interquartile range (IQR<\/jats:styled-content>) 8\u201314] years; 53.3% of patients were male. At enrolment, the median cART<\/jats:styled-content> duration was 3.3 (IQR<\/jats:styled-content> 1.1\u20136.1) years; 177 (25.1%) and 83 (11.8%) patients had elevated AST<\/jats:styled-content> and alanine aminotransferase (ALT<\/jats:styled-content>), respectively. A tenth of the children had an APRI<\/jats:styled-content> score > 0.5, suggesting liver fibrosis. Being on a zidovudine (ZDV)\u2010 or nevirapine (NVP<\/jats:styled-content>)\u2010based regimen and having a viral load > 1000 HIV\u20101 RNA copies\/mL were significantly associated with elevated ALT<\/jats:styled-content>. Twenty\u2010four (3.4%) and 84 (12.1%) patients had elevated creatinine and blood urea nitrogen (BUN<\/jats:styled-content>), respectively. As cART<\/jats:styled-content> duration increased by 6 months, median BUN<\/jats:styled-content> increased by 1.6 [95% confidence interval (CI<\/jats:styled-content>) 0.4\u20132.7] mg\/dL<\/jats:styled-content> (P<\/jats:italic> = 0.01); the glomerular filtration rate (GFR) decreased by 35.6 (95% CI<\/jats:styled-content> 17.7\u201353.4) mL<\/jats:styled-content>\/min\/1.73 m2<\/jats:sup> (P<\/jats:italic> < 0.0001); and AST<\/jats:styled-content> and ALT<\/jats:styled-content> decreased by 1.4 (95% CI<\/jats:styled-content> 0.4\u20132.5) IU<\/jats:styled-content>\/L (P<\/jats:italic> = 0.01) and 1.4 (95% CI<\/jats:styled-content> 0.2\u20132.6) IU<\/jats:styled-content>\/L (P<\/jats:italic> = 0.01), respectively.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>A high prevalence of liver enzyme and renal function abnormalities was observed at enrolment. Decreasing liver enzyme levels during follow\u2010up are possibly reassuring, while the progressive reduction in GFR<\/jats:styled-content> and the increase in BUN<\/jats:styled-content> are worrisome and require further study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12693","type":"journal-article","created":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T10:17:56Z","timestamp":1543227476000},"page":"147-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Hepatic and renal toxicity and associated factors among HIV\u2010infected children on antiretroviral therapy: a prospective cohort study"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4005-8605","authenticated-orcid":false,"given":"BT","family":"Tadesse","sequence":"first","affiliation":[{"name":"Department of Pediatrics College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia"},{"name":"Division of Clinical Pharmacology Department of Laboratory Medicine Karolinska Institute Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BA","family":"Foster","sequence":"additional","affiliation":[{"name":"Departments of Dermatology and Pediatrics Oregon Health Sciences University Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Kabeta","sequence":"additional","affiliation":[{"name":"School of Nursing College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Ayalew","sequence":"additional","affiliation":[{"name":"School of Laboratory Medicine College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"H\/Meskel","sequence":"additional","affiliation":[{"name":"School of Laboratory Medicine College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Jerene","sequence":"additional","affiliation":[{"name":"Management Sciences for Health Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Makonnen","sequence":"additional","affiliation":[{"name":"CDT Africa College of Health Sciences Addis Ababa University Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Aklillu","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology Department of Laboratory Medicine Karolinska Institute Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,26]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"UNAIDS.UNAIDS Data 2017. 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