- Dr Alok Hemal, Dr Gopila Gupta, Dr. Kanika Kapoor, Dr Abhijeet Saha, Dr. Parul Goya
Objective: To study the prevalence of proteinuria in unselected HIV infected children aged 18 months to 18 years attending paediatric ART clinic.
INTRODUCTION-HIV infection is increasingly becoming a prominent cause of childhood morbidity and mortality in India. HIV-1 associated nephropathy (HIV AN) is a clinical and histological disease characterised by heavy proteinuria and nephrotic syndrome leading to rapid progression to chronic renal failure. There are several studies regarding renal manifestations in children from American and African regionsbut there is paucity of studies on the prevalence of HIV AN from India, with data limited to anecdotal case reports. Hence, the present study was planned with the aim of studying the prevalence of HIV AN in HIV infected children.
Methods: : In this cross sectional study 139 HIV infected children between age group 18 months and 18 years were recruited from the ART centre of a tertiary care hospital in New Delhi, India. Persistent proteinuria was diagnosed by urinary dipstick finding of 1+ or more on two or more occasions in the absence of fever and a urine protein-to- creatinine ratio (each measured in mg/dl) of ≥ 0.2. Urine protein and urine creatinine were measured by colorimetric and an enzymatic method respectively. If the above mentioned criteria was negative then urinary albumin to creatinine ratio was measured to detect microalbuminuria (ACR = 30 – 300 mg/g) by collecting urine sample in the subsequent visit. Urinary albumin was measured by using immune-turbidimetric method
The prevalence of proteinuria in this study was 11.5%. Prevalence of microalbuminuria was 10.6% in normoproteinuric group and 9.35 % in the total study population. The prevalence of albuminuria (urinary ACR ≥ 30 mg/g) was 20.9% among HIV positive cases. The prevalence of proteinuria increased with WHO staging, 8.05% in stage 1 to 26.32% in stage 3+4 (Table1). No statistically significant relation of proteinuria or microalbuminuria was found with duration of HAART and CD4 count.
: Screening for proteinuria and microalbuminuria can help in early detection of renal disease in HIV positive patients, which may help in decreasing the progression of to ESRD by early institution of appropriate therapy.
A. Hemal Sr., None