Ibrahim Halima Umar, Elechi Hassan Abdullahi, Rabasa Adamu Ibrahim, Ashir Garba Mohammed, Farouk Abubakar Garba, Yauba Mohammed Saad, Ibrahim Bello Abdullahi
Department of Pediatrics, Federal Medical Center, Birnin-Kudu, Jagawa State, Nigeria.
Department of Pediatrics, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Saudi J Kidney Dis Transpl. 2019 Jul-Aug;30(4):843-852. doi: 10.4103/1319-2442.265460.
The kidney is an important target organ in human immunodeficiency virus (HIV) infection, and a variety of renal disorders could occur throughout the course of the disease. HIV- associated nephropathy (HIVAN) is the most common form of kidney disease resulting directly from HIV infection. The true prevalence of HIVAN among infected African children is unknown largely due to lack of surveillance and reporting. We thus aimed to determine the prevalence of HIVAN and associated factors among HIV-infected children at the University of Maiduguri Teaching Hospital. This was a cross-sectional study carried out at the Pediatric Infectious Clinic. Children aged ≤15 years were recruited through systematic random sampling. Relevant sociodemographic and clinical information were obtained. Spot urine sample was analyzed using a multistix (Combi-Screen 10SL Analyticon Biotechnologies AG, Germany), and proteinuria of ≥2+ was considered significant. The CD4+ count and CD4+% (for those <5 years) were obtained using a PARTEC™ CD4+ easy count kit. The obtained data were entered and analyzed using Statistical Package for the Social Sciences version 16.0. A total of 250 children were recruited. Eighty-five (34%) of them had HIVAN. Sex, social class, and mode of transmission were not significantly associated with HIVAN (P >0.05). However, age, medication status (highly active antiretroviral therapy [HAART]), duration on HAART, and disease severity (both clinical and immunological) all had a significant association to HIVAN (p = 0.005, 0.004, 0.008, and <0.001, respectively). These factors also showed a positive but weak correlation to HIVAN; while age had the least correlation coefficient (0.157), immunological class had the highest r = 0.458. However, these relationships were all significant (P <0.5). HIVAN is highly prevalent among children living with HIV in Maiduguri. Routine screening through urina-lysis and early commencement of HAART is recommended.
肾脏是人类免疫缺陷病毒(HIV)感染中的一个重要靶器官,在该疾病的整个病程中可能会出现多种肾脏疾病。HIV相关性肾病(HIVAN)是直接由HIV感染导致的最常见的肾脏疾病形式。在受感染的非洲儿童中,HIVAN的真实患病率很大程度上未知,这主要是由于缺乏监测和报告。因此,我们旨在确定迈杜古里大学教学医院中HIV感染儿童的HIVAN患病率及相关因素。这是一项在儿科传染病诊所进行的横断面研究。通过系统随机抽样招募年龄≤15岁的儿童。获取了相关的社会人口统计学和临床信息。使用多联试纸(德国Analyticon Biotechnologies AG公司的Combi-Screen 10SL)分析即时尿样,蛋白尿≥2+被认为具有显著性。使用PARTEC™ CD4+简易计数试剂盒获取CD4+细胞计数和CD4+%(针对<5岁的儿童)。将获取的数据录入并使用社会科学统计软件包第16.0版进行分析。总共招募了250名儿童。其中85名(34%)患有HIVAN。性别、社会阶层和传播方式与HIVAN无显著相关性(P>0.05)。然而,年龄、用药状况(高效抗逆转录病毒治疗[HAART])、HAART治疗时长以及疾病严重程度(临床和免疫学方面)均与HIVAN有显著相关性(分别为p = 0.005、0.004、0.008和<0.001)。这些因素与HIVAN也呈现出正相关但较弱的关系;年龄的相关系数最小(0.157),免疫学分级的r值最高,为0.458。然而,这些关系均具有显著性(P<0.5)。在迈杜古里,HIVAN在感染HIV的儿童中高度流行。建议通过尿液分析进行常规筛查并尽早开始HAART治疗。