Prevalence and Risk Factors for Albuminuria among HIV Ivorian Children, Using the Dipstick Method

Abstract

Context : Human immunodeficiency virus (HIV) infected children are at risk of developing chronic kidney disease defined by decreased glomerular filtration rate and or proteinuria. Studies on the prevalence of and risk factors for proteinuria among HIV-infected children in sub-Saharan Africa are scarce and in Cote d’Ivoire, there is paucity of reported data. We determined the prevalence of and the risk factors for proteinuria among HIV-infected Ivorian children in both ART (antiretroviral therapy)-naïve and ART-exposed children. Method : It was a cross-sectional bi-centric study, conducted from July 2013 to April 2014. Each child’s urine was tested for proteinuria and microalbuminuria using multi test strips and mitral test, respectively. Proteinuria was defined as of significant of 1+ and above on the dipstick or the presence of microalbuminuria ≥ 20 mg/l. Results : Of the 155 HIV-infected children enrolled, there were 78 boys. Sixty seven point seven percent were treated with antiretroviral and 74.1% had treatment duration of less than 5 years. In the first dipstick test, the prevalence of proteinuria was 29% which persisted in 9.7% after 24 hour urinary protein examination. It was significantly different between the 2 groups treated and naïve (2.8% versus 24%). The advanced CDC clinical stage emerged as the main independent determinant of proteinuria. Conclusion : Proteinuria is common in HIV-infected Ivorian children. Screening for proteinuria in HIV-infected children will help in early and treatment, and thus prevention and progression to chronic kidney disease to end-stage kidney disease.