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 of 4-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.