[Prevalence of proteinuria in children followed-up for HIV infection at Pediatric University Hospital Charles-de-Gaulle (CHUP-CDG) of Ouagadougou].

In subjects infected with HIV, proteinuria could represent a marker of HIV associated nephropathy (HIVAN), the most important cause of chronic renal failure in them. To determine the prevalence of proteinuria in children with HIV infection and to improve the screening of renal disease for these children in our country, we conducted a descriptive cross-sectional study over a 3-month period. We included 122 children (0-14 years old) with HIV infection followed at CHUP-CDG. Proteinuria was calculated using the first morning urine sample by dipstick test (significant for a "+" or more). Statistical tests were significant for p < 0.05. The 122 children (121 HIV1 and 1 HIV2) comprised of 64 boys and 58 girls. Eighteen (14.8%) (14 boys and 4 girls) had proteinuria (1 or 2 "+"). The mean age of patients with proteinuria was 10.4 ± 3.3 years. None of the children were hypertensive. All were infected with HIV1. Proteinuria was associated with microscopic hematuria in six cases. The average CD4 count was 21 ± 8% versus 23 ± 10% in 42 patients without proteinuria (p = NS). The mean serum creatinine in patients with proteinuria was 47 ± 29 μmol/l. Three of them had acute renal failure. All patients with proteinuria had antiretroviral treatment (ARV) since 40 ± 24 months versus 36 ± 26 months in 98 patients without proteinuria. No treatment included tenofovir, indinavir, or converting enzyme inhibitor. The prevalence of proteinuria in our sample is lower than that reported by other African writers in untreated subjects. This fact suggests a nephroprotection of ARV in our patients probably treated early and effectively. However, microalbuminuria, a possible early marker of HIVAN, has not been evaluated by our study. Studies of the prevalence of microalbuminuria in children infected with HIVand treated with ARVs in Sub-Saharan African countries should be encouraged. They would help to determine the relevance in these children of research routinely of microalbuminuria and to screen and precociously take care of a possible HIVAN or other chronic glomerulopathy.