Renal Echogenicity as a Predictor of Human Immunodeficiency Virus–Associated Nephropathy: A Cross-Sectional Study at a Tertiary Hospital in Lagos, Southwest Nigeria

Abstract

The objective of this study was to determine the accuracy of sonography in a human immunodeficiency virus–associated nephropathy (HIVAN) diagnosis. A sample of 340 HIVAN patients underwent laboratory CD4+ count, serum creatinine/glomerular filtration rate (GFR) estimation, and sonographic echogenicity grading. The accuracy of sonography in predicting an HIVAN diagnosis was calculated. Mean CD4+ count, serum creatinine, and GFR for male and female HIVAN patients was 153.1 ± 103.2 cells/mm3 and 121.9 ± 91.0 cells/mm3, 218.4 ± 147.4 mmol/L and 222.0 ± 150.4 mmol/L, and 50.1 ± 23.6 mL/min/1.73 m2 and 39.3 ± 20.6 mL/min/1.73 m2, respectively; 56.9% of patients had echogenicity grade 3. On the basis of CD4+ count, serum creatinine, and GFR, the area under the curve was 0.76 and ≈ 1, respectively; the area under the curve was 0.63, 0.79, 0.70, 0.79 and 0.91, 0.99, 1, 1 for grades 0, 1, 2, and 3 echogenicity, respectively. With a high level of apathy to voluntary HIV/AIDS screening and late patient presentation, sonography (grade 3 renal echogenicity) can assist in predicting an HIVAN diagnosis.