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

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