Urinary findings in HIV positive children by dipstick screening test in Enugu

Abstract

Abstract Background: Human immunodeficiency virus (HIV) affects
the kidney. Urine screening for abnormalities can detect early renal
parenchymal diseases.
Objectives: To determine the prevalence of abnormal urinary findings
in HIV positive children in University of Nigeria Teaching Hospital,
(UNTH), Enugu.
Method: Urinary screening was carried out in 159 HIV positive children in UNTH over a period of4-
months, to detect presence of abnormalities such as glycosuria, proteinuria, haematuria, as well as the presence of nitrite and leucocyte esterase, abnormal urine pH and specific gravity (SG).
Results: Eighty males and 79 females were screened. Five (5), 4,
and a child had proteinuria, SG of >
1.015 and alkaline urine, giving a
prevalence rate of 3.1%, 2.5% and
0.6% respectively. Neither of the
subjects had glycosuria, haematuria
nor tested positive to nitrite and
leucocyte esterase. Subjects with
proteinuria were older (5-14 years),
had longer duration of HIV diagnosis, longer duration of treatment
with HAART, and a lower CD4 cell
count (p=0.01). Sixty percent of
those with proteinuria had severe
immunosuppression, with 4 out of
the 5 of them with urine SG more
than 1.015. The children with urine
SG more than 1.015 were among
the older age group (5-14 years), on
HAART, had non-advanced HIV
disease as well as low CD4 cell
count (p= <0.0001).
Conclusion: Urinary abnormalities
occur among HIV infected children.
Longer duration of HIV diagnosis,
older age and low CD4 cell count,
are probable factors associated with
proteinuria.We recommend routine
urinary examination for HIV positive children.
Key words: Urinary abnormalities,
proteinuria, advanced HIV disease,
immunosuppression