6425 Comparative assessment of glomerular and proximal tubular function among HIV infected and uninfected children in Makurdi, Nigeria

Objectives The use of Highly Active Anti-Retroviral Therapy (HAART) as a treatment modality has led to an increase in the survival of people living with Human immunodeficiency virus (HIV) infection with accompanying overall increase in the frequency of some non-communicable diseases; particularly kidney diseases owing to drug toxicity, co-morbid chronic medical conditions and co-infection with other chronic viral illnesses.¹ ² HIV infection is a known risk factor for kidney disease and Makurdi, Nigeria has a huge burden of the infection.³ This study determined the prevalence and risk factors of glomerular and proximal tubular dysfunction among children living with HIV attending tertiary health institutions in Makurdi, Nigeria. Methods This was a cross-sectional analytical study involving children aged 18 months to 17 years distributed into 91 children living with HIV and 91 age and sex-matched uninfected children for comparison. Relevant information was obtained from administered questionnaire and clinical records of these children. Blood samples for serum creatinine and urine samples for β2-microglobulin, albumin and creatinine were collected from each study participant. Data was analysed using SPSS version 23.0 and level of significance was taken as <0.05. Results The prevalence of albuminuria was 65.9% (n = 60) among children living with HIV and 64.8% (n = 59) among comparison group (p = 0.876). The prevalence of reduced GFR was 5.5% (n = 5) among children living with HIV and 1.1% (n = 1) among the comparison group (p = 0.211). Table 1 shows overall prevalence of glomerular dysfunction was 4.4% (n = 4) among children living with HIV compared with 0% (n = 0) among comparison group (p = 0.115). Figure 1 shows prevalence of proximal tubular dysfunction was 93.4% (n = 85) among children living with HIV compared with 73.6% (n = 67) among comparison group (p = 0.001) The use of HAART for less than 60 months was identified as a risk factor for albuminuria [OR 2.69 (CI 1.040–6.958) p = 0.041]. Risk factors associated with reduced GFR were older age group [OR 0.670 (CI 0.513–0.876) p = 0.003], use of HAART for <60 months [OR 0.958 (CI 0.920 – 0.998), p = 0.038], and use of Tenofovir-based HAART regimen [OR 0.111 (CI 0–0.847) p = 0.032]. HIV infection was the only factor associated with proximal tubular dysfunction [OR 5.075 (CI 1.962 – 13.124) p = 0.001]. Conclusion Glomerular and proximal tubular dysfunction are common among children living with HIV attending tertiary health institutions in Makurdi. References Phair J, Palella F. Renal disease in HIV infected individuals. Curr Opin HIV AIDS. 2011;6(4):285–28. Smith C, Sabin CA, Lundgren JD, Thiebaut R, Weber R, Law M, et al. Factors associated with specific causes of death amongst HIV-positive individuals in the D:A:D Study. AIDS. 2010;24(10):1537–1548. National Agency for the Control of HIV/AIDS (NACA). Nigeria Prevalence Rate. Available at: https://naca.gov.ng/nigeria-prevalence-rate/