Hepatic and Renal Functions in HIV-Positive Children with Malaria in Western Kenya

Abstract

Background: The burden of HIV and malaria co-infection lies disproportionately in the Sub-Saharan Africa region which bears most of the malaria endemic zones. While both malaria and HIV are known to dysregulate hepatic and renal functions, the combined effect of co-infection with malaria and HIV on hepatic and renal function among children remains poorly characterized.

Objective: To assess liver and renal functions in HIV-malaria co-infected children in Western Kenya.

Methods: A cross-sectional study was conducted among children aged 6-59 months with HIV and malaria coinfection at Kakamega County Referral Hospital, Western Kenya. A total of 138 children were enrolled. Microscopy and clinical chemistry analysers were used to diagnose malaria, and assay hepatic and renal function parameters respectively.

Results: HIV positive-malaria positive cases had significantly higher serum creatinine and urea levels compared to the HIV positive-malaria negative controls. Likewise, serum levels of the alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total protein, albumin and globulin were significantly elevated in the HIV and malaria-positive cases compared to HIV-positive and malaria-negative controls. Significantly higher proportions of children with HIV and malaria coinfection also had elevated serum levels of ALT, ASP, GGT, total proteins, albumin and globulin compared to children without coinfection. Serum levels of Alkaline phosphatase (ALP) and Lactate dehydrogenase (LDH) were comparable in both groups.

Conclusion: Co-infection with HIV and malaria among children is generally associated with disrupted hepatic and renal function parameters.