Effect of Stalanev and Zidolam on kidney function of HIV positive children attending Parirenyatwa General Hospital, Opportunistc Infections Clinic, Harare, Zimbabwe

Abstract

Objective: To investigate the relationship between antiretroviral regimens used in a national HIV treatment programme and development of nephropathy in pediatric patients.
Study Design: An analytical cross sectional study carried out from January 2011 to September 2011.
Setting: The Opportunistic Infections Clinic (OI Clinic) at Parirenyatwa General Hospital, Harare.
Subjects: HIV positive pediatric patients attending Parirenyatwa General Hospital Opportunistic Infections (OI) clinic.
Results: Based on serum creatinine levels >88.4μmol/L 0.02% (n=3) of the Human Immunodeficiency Virus (HIV) positive participants on Antiretroviral Treatment (ART) had kidney dysfunction whereas only 0.9% (n=1) had serum cystatin C levels>1.27mg/L indicating kidney dysfunction. Using a microalbuminuria cut off point of 30mg/L, there was no statistical difference in the microalbumin levels between the Highly Active Antiretroviral Therapy (HAART) experienced (7.5 mg/L) and the HAART naïve (4.6mg/L) children, p=0.02. There was no statistically significant difference in serum creatinine, urine microalbumin, serum cystatin C, eGFR based on creatinine and eGFR based on cystatin C between participants on ART and ART naïve (p>0.05) .
Conclusion: Our results confirm that serum creatinine levels and cystatin C levels are not sensitive markers for the early detection of nephropathy in children on HAART. The results indicate that both HIV seropositivity and HAART contributed to the development of HIV associated nephropathy as defined by microalbuminuria in Zimbabwean children.