%0 Journal Article
%T Screening for Microalbuminuria in HIV-Positive Children in Enugu
%A Ezeonwu Bertilla Uzoma
%A Okafor Henrietta Uchenna
%A Ikefuna Anthony Nnaemeka
%A Oguonu Tagbo
%J International Journal of Nephrology
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/805834
%X Background. Human immunodeficiency virus associated nephropathy (HIVAN) is a rapidly progressive chronic renal parenchymal disease that occurs in HIV-infected individuals and manifests commonly as proteinuria, which is preceded by microalbuminuria (MA). This clinical entity is defined as a spot urine albumin of 20¨C200£¿mg/L. Objectives. To determine the prevalence of microalbuminuria in HIV positive children in UNTH, Enugu and compare it with that of HIV-negative children. Methods. A total of 154£¿HIV positive children aged 18 months to 14 years and 154£¿HIV-negative children of corresponding attributes were screened for microalbuminuria, using Micral test II strip which has a sensitivity of 90¨C99%. Results. No child among the groups (HIV positive and negative) had microalbuminuria. Majority (96.0%) of HIV-positive children had nonadvanced HIV disease at the time of the study ( ). About 77.3% were using HAART ( ), the mean CD4 cell count of the subjects was cells/mm3; while 78.0% had nonsevere immunosuppression ( ). Furthermore, HIV-positive children with severe immunosuppression were younger and had shorter duration of treatment. Conclusion. Microalbuminuria may not be very common in Nigerian children irrespective of their HIV status. 1. Introduction Nigeria contributes 9% to global HIV burden, and has a seroprevalence of 4.6% with 220,000 children already living with HIV infection as of 2008 [1, 2]. Human immunodeficiency virus (HIV) affects many organs including the kidney [3]. HIV renal parenchymal disease is varied and may result from direct effect of the virus on renal epithelial cells, immune-complex mediated vasculitis, hyperviscosity of blood secondary to hyperglobulinaemia, various opportunistic infections, and also drugs [4]. The commonest chronic renal parenchymal disease in HIV-positive patients is HIV-associated nephropathy (HIVAN) [5, 6], which occurs in childhood [6¨C9] and has been documented in Nigerian children too [9, 10]. HIVAN progresses to ESRD but if detected early, this progression can be slowed or even halted with the use of HAART [6]. The commonest manifestation of HIVAN is proteinuria, [5, 11] which has been described in HIV-positive children [6, 9] and Esezobor and colleague [9] in Nigeria documented a prevalence of 20.5% in HIV-positive Nigerian children. Microalbuminuria is a predictor of subclinical renal involvement in systemic diseases including HIVAN [3]. It precedes proteinuria [3] and has been shown to be an early manifestation of HIVAN [3]. Therefore, the detection of microalbuminuria as well as the prompt institution
%U http://www.hindawi.com/journals/ijn/2012/805834/