Sonographic characterization of renal pathologies in HIV/AIDS in Plateau State, Nigeria.

BACKGROUND

The prevalence of HIV/AIDS in Jos is about 7% according to Idoko et al. Many deaths from infection occur from the complications involving vital organs. The effects of this complication on the kidneys being one of the vital organs are yet to be determined in the locality. The kidneys are prone to impairment due to direct viral attack, opportunistic infections and nephrotoxic drugs. Though renal sonographic features are well characterized in literature, there is no documentation of correlation between renal sonographic features in HIV/AIDS and healthy population in Nigeria. The objectives of the study are to determine the commonly occurring renal sonographic features in HIV/AIDS in terms of echogenicity and size, and correlate these features with measured CD4 cell count.

METHODS

302 subjects were studied prospectively over a period of twenty two months. In order to determine renal sizes, several bilateral longitudinal and transverse scans of the subjects' kidneys in a supine position were done. In order to clarify renal echogenicity, a-four point scoring method was devised to measure the severity of sonographic changes in the kidneys. Subjects' CD4 cell counts were collected from the APIN laboratory and Faith Alive Foundation both in Jos. Pearson's correlation and regression were used for correlation between CD4 cell count and renal length, and between renal length and age, and Z-test was used to compare mean renal dimension of male and female of subjects and HIV sero negative subjects.

RESULTS

The subjects consisted of 123 males and 179 females with a mean age of 34.4 years, between the ages of 4 and 80 years. Results indicated that 77.7% of subjects had increased renal echogenicity reflecting the prevalence of renal disease in HIV/AIDS in the locality, 76.7% of the subjects were in their reproductive and sexually active ages (21-40 years). There was significant negative correlation between renal length and measured CD4 cell count (p < 0.01) and also between renal length and age of subjects (p < 0.05). No significant correlation between renal echogenicity and CD4 cell count was noted. Result also indicate that renal length is related to CD4 cell count by the equation = 0.0029CD4+11.1423.

CONCLUSION

It is concluded that sonographic features of the kidneys in HIV infection in this locality is characterized by increased renal length with decreasing CD4 cell count amongst sexually active age group. And also a generally high incidence of renal involvement (disease) in HIV/AIDS is seen, similar to those reported in literatures.