Kidney Injury in Children Infected with HIV, Followed at the Teaching Hospital of Borgou (Benin)

Abstract

The history of kidney disease associated with HIV infection dates back to the years of HIV breakthrough. The objective was to study kidney damage in children infected with HIV at the Teaching Hospital of Borgou (Benin) in 2019. This was a cross-sectional, descriptive, analytical, matching-type study carried out from June 1, 2019 to September 30, 2019 at the pediatrics department of Teaching Hospital of Borgou (Benin). The study included HIV-positive children, followed in consultations, and whose parents gave their consent. The biological markers were demon-strated with urine dipstick. Glomerular filtration rate was calculated using the Schwartz test and classified according to stages. The dependent variable was the presence of at least one impairment (biological or functional). Sample size was determined by Schwartz’s method on the basis of one case for two controls. Sociodemographic, clinical, biological, and therapeutic data were collected. Comparisons were made using the Chi-square test or Fisher’s exact test. The identification of associated factors was possible using a multiple logistic regression model at 5% threshold. In total, we included 117 children, including 39 HIV-positive children. The average age was 8 ± 4.81 years and the gender ratio was 1:17. The frequency of kidney damage was 76.5%. Permanent proteinuria and at least two crosses on urine dipstick were present in 20.5%, leukocyturia in 2.6%, and proximal tubular dysfunction in 5.1%. Glomerular hyperfiltration was found in 38.5%, acute kidney injury in 38.5%, and chronic kidney injury in 5.1%. Associated factors were age (P = 0.004), presence of opportunistic infections (P = 0.00), and treatment adherence (P = 0.004). Kidney damage is common in HIV-positive children. Careful follow-up is necessary to avoid complications.

Prevalence of Microalbuminuria and Associated Risk Factors in HIV-Infected Children seen at a Tertiary Health Centre in the Niger Delta Region of Nigeria

“…Similar findings have been reported by Okechukwu et al in Abuja and Fredrick et al in Tanzania [6,9]. This is lower than that reported by Ahoui et al in Benin Republic (38.5%) but higher than report by Esezobor et al in Lagos (13.3%) [26,27]. The varying rates is as a result of the different eGFR cut off values for renal impairment, the methods used in estimating GFR and the stage of HIV associated kidney disease of the subjects.…”

“…The varying rates is as a result of the different eGFR cut off values for renal impairment, the methods used in estimating GFR and the stage of HIV associated kidney disease of the subjects. The eGFR cut off values for the index study was higher (60 -90) than the cut off values from the Lagos study (30 -60), [27] but similar to that of the Benin Republic study [26]. Also, while the index study used the creatinine-based formula for GFR estimation, the Lagos study [27] used Cystatin C. The use of Cystatin C-based formula has been argued to be more accurate than the GFR derived from the widely used creatinine-based formula because it is less affected by nonglomerular factors such as lean mass, diet, and tubular secretion [8].…”

“…The findings of normal renal length and echogenicity in this study buttresses the fact that MA is an early manifestation of HIV related kidney disease. Ahoui et al in Benin Republic reported increased echogenicity in 25.6% of their subjects [26]. Other studies with finding of increased echogenicity include; Okechukwu et al in Abuja (4.7%), Fredrick et al in Tanzania (39.2%) [6,9].…”

“…Increased echogenicity is a late manifestation of HIV related kidney disease which the subjects in the index study did not have. Ahoui et al in Benin Republic studied subjects with fully established HIV related kidney disease which may account for the high prevalence of increased echogenicity in their study compared to the index study [26].…”

Renal Impairment Impact and Survival Analysis in a Romanian Cohort of HIV-1(F1)-Infected Children and Adolescents

“…In addition, HIV by itself, ARV treatment and metabolic syndrome may lead to hyperfiltration due to insulin-like growth factor [28]. Similar data, of a 24% hyperfiltration status, was found in a cohort of HIV-infected children in Benin, which was more frequently encountered in children receiving ARV treatment [29].…”