Context: Human immunodeficiency virus (HIV) infected children are at risk of developing chronic kidney disease defined by decreased glomerular filtration rate and or proteinuria. Studies on the prevalence of and risk factors for proteinuria among HIV-infected children in sub-Saharan Africa are scarce and in Cote d'Ivoire, there is paucity of reported data. We determined the prevalence of and the risk factors for proteinuria among HIV-infected Ivorian children in both ART (antiretroviral therapy)-naïve and ART-exposed children. Method: It was a cross-sectional bi-centric study, conducted from July 2013 to April 2014. Each child's urine was tested for proteinuria and microalbuminuria using multi test strips and mitral test, respectively. Proteinuria was defined as of significant of 1+ and above on the dipstick or the presence of microalbuminuria ≥ 20 mg/l. Results: Of the 155 HIV-infected children enrolled, there were 78 boys.Sixty seven point seven percent were treated with antiretroviral and 74.1% had treatment duration of less than 5 years. In the first dipstick test, the prevalence of proteinuria was 29% which persisted in 9.7% after 24 hour urinary protein examination. It was significantly different between the 2 groups treated and naïve (2.8% versus 24%). The advanced CDC clinical stage emerged as the main independent determinant of proteinuria. Conclusion: Proteinuria is common in HIV-infected Ivorian children. Screening for proteinuria in HIV-infected children will help in early and treatment, and thus prevention and progression to chronic kidney disease to end-stage kidney disease.
Background: Viral hepatitis C is a major public health problem in the world. The advent of direct-acting antivirals has revolutionized the taking in charge and prognosis of patients infected with the hepatitis C virus. The interest of this presentation is to draw attention to the problem of therapeutic care posed by viral hepatitis C in kidney transplant patients in Côte d'Ivoire, a country with limited resources where all direct-acting antivirals are not yet available. Patient observation: We report the case of a kidney transplant of 52 years old, chronic bearer of viral hepatitis C virus who after his kidney transplant presented, decompensated active cirrhosis. A treatment based on Sofosbuvir 400 mg/Ledipasvir 90 mg in this patient with genotype 2 for 12 weeks was initiated. A sustained virological response was observed 12 weeks after the end of treatment. Conclusion: Direct-acting antivirals offer the possibility of antiviral C treatment without interferon or ribavirin in cirrhotic renal transplant.
Nephrology is a new discipline in sub-Saharan Africa. For a better management of various nephropathies, histological data are necessary in terms of diagnosis, therapy as well as prognosis. However, performing renal needle biopsy is very challenging. We are reporting inadequacy of human, material and financial resources for histological data collection through a case of 21-yearold patient with lymphoma complicated by acute renal failure (ARF).
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