Abstract
IntroductionHuman Immunodeficiency Virus (HIV) infection is a significant cause of paediatric morbidity and mortality especially in Sub-Saharan Africa. It affects the kidney by injuring the glomerular and tubular epithelial cells causing leakage of albumin in urine. Microalbuminuria is known to be an early indicator of kidney injury including HIVAN. The purpose of this study was to identify the prevalence and factors associated with microalbuminuria among HIV infected children receiving care and treatment at Kilimanjaro Christian Medical Centre (KCMC).MethodsWe conducted a cross sectional hospital based analytical study at KCMC from December 2012 to April 2013. It involved children who are HIV infected attending child centred family care clinics (CCFCC). Patients’ demographic and clinical characteristics were extracted from the file; physical examination performed. Urine samples were analysed for by HemoCue Albumin 201 system analyzer. Statistical package for social sciences (SPSS) version 16.0 was be used to process and analyze the data.ResultsThree hundred thirty HIV-infected children under 18 years were recruited during the study period. Mean age was 119.4 (5-218) months. Prevalence of microalbuminuria by using HemoCue Albumin 201 analyzer was 28.8% (n = 95). Presence of microalbuminuria was significantly associated with severity of HIV disease progression according to WHO disease stage (p = 0.0015) and CD4 count less than 350 cells/µL (p = 0.044).ConclusionThe study has shown that microalbuminuria is common in HIV infected children. Early screening and treatment of microalbuminuria is important to minimize the risk of developing end stage kidney disease. Children with advanced HIV disease and those with CD4 count less than 350cells/µL should be given priority for urinary albumin screening in a setting without routine screening for microalbuminuria.
Highlights
Human Immunodeficiency Virus (HIV) infection is a significant cause of paediatric morbidity and mortality especially in SubSaharan Africa
Tanzania has been hit by the AIDS pandemic the current estimates are beginning to show a decline in prevalence from 5.7% in 2009 to the current 5.1%; with an estimated population of 43 million, it has about 2 million people living with HIV, 10% of whom are children below the age of 15 years [1, 2]
Those on TB medication, with sickle cell disease and diabetes mellitus, and those using highly active antiretroviral therapy (HAART) containing tenofovir based combination were excluded from the study as they are confounders
Summary
Human Immunodeficiency Virus (HIV) infection is a significant cause of paediatric morbidity and mortality especially in SubSaharan Africa. It affects the kidney by injuring the glomerular and tubular epithelial cells causing leakage of albumin in urine. The purpose of this study was to identify the prevalence and factors associated with microalbuminuria among HIV infected children receiving care and treatment at Kilimanjaro Christian Medical Centre (KCMC). Methods: We conducted a cross sectional hospital based analytical study at KCMC from December 2012 to April 2013 It involved children who are HIV infected attending child centred family care clinics (CCFCC). As the life span of HIV infected children improved due to antiretroviral (ARV) medications we are seeing late complications of HIV infection like renal complications [4]
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