Kidney Injury in Children Infected with HIV, Followed at the Teaching Hospital of Borgou (Benin): Epidemiological and Clinical Aspects
Main Article Content
Keywords
Benin, HIV-positive, kidney disease, pediatrics
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 demonstrated 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.
References
2. Organisation Mondiale de la Santé. Le VIH chez l’enfant. [Enligne]. 2006. [Consulté le 19 Janvier 2019]. Available from: www.who.int/children2
3. Pardo V, Aldana M, Colton RM, Jaffe D, Moskowitz L, Hensley GT, Bourgoignie, JJ. Glomerular lesions in the acquired immunodeficiency syndrome. Ann Intern Med. 1984;101:429–34. 10.7326/0003-4819-101-4-429
4. Gardenswartz MH, Lerner CW, Seligson GR, Zabetakis PM, Rotterdam H, Tapper ML, Michelis MF, Bruno MS. Renal dis-ease in patients with AIDS: A clinicopathological study. Clin Nephrol. 1984;21:197–204.
5. Pardo V, Meneses R, Ossa L, et al. AIDS-related glomer-ulopathy. Occurrence in specific risk groups. Kidney Int. 1987;31:1167–73. 10.1038/ki.1987.124
6. Kopp JB, Winkler C. HIV-associated nephropathy in African Americans. Kidney Int 2003;83:43–9. 10.1046/j.1523-1755.63.s83.39.x
7. Freedman BI, Soucie JM, Stone SM, Pegram S. Familial clustering of end stage renal disease in blacks with HIV-associated nephropathy. Am J Kidney Dis. 1999;34:254–8. 10.1016/S0272-6386(99)70352-5
8. Mfutu Ekulu P, Mangasi Nséba N, Ntetani Aloni M, Etungu Gini, Mabulo J-R, et al.Prévalence de la protéinurie et son association avec le VIH/SIDA chez l’enfant à Kinshasa. Néphropathie et Thérapeutique. 2012;8(3):163–7. 10.1016/j.nephro.2011.09.004
9. Vigan J , Azon K , Agboton B, Houngbe C. Prévalence de l’insuffisancerénale et facteursassociés chez les patients traités par ARV au CNHU-Cotonou. Néphrologie et Thérapeutique. 2014;10(5):396. 10.1016/j.nephro.2014.07.120
10. Ahoui S, Dovonou CA, Vigan J, Fagnihoun AS, Alassani A, Atinsounon AC, et al. Incidence et facteursassociés à l’insuffisancerénaleaigue chez les personnes vivant avec le virus d’immunodeficienceacquise (PVVIH) traitées par le Tenofovir au CHUD Borgou. Juin 2016. Médecine et Santé Publique. 2016;9 :99–113.
11. Djadou KE, Azoumah DR, Saka B, Douti K, Koudaya K, Tatagan-Agbi K, Agbèrè AD. Suivi des enfants infectés par le VIH sous traitement antiretroviral dans une zone rurale du Togo; Médecine et Santétropicales. 2012; 22(3):283. 10.1684/mst.2012.0070
12. Schwartz GJ, Muñoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol : JASN. 2009;20(3):629. 10.1681/ASN.2008030287
13. Konus L, Ozdemir A, Akkaya A, Erbas G, Celik H, Isik S. Normal liver, spleen, and kidney dimensions in neonates, infants, and children: Evaluation with sonography. AJR Am J Roentgenol. 1998;171:1693–8. 10.2214/ajr.171.6.9843315
14. Organisationmondiale de la Santé. La priseen charge de la mal- nutrition sévère: Manuel à l’usage de médecins et autresper- sonnels de santé à des postesd’encadrement [Internet]. Genève. 2000 Available from: who.int/iris/bitstream/handle/10665/42272/a67663.pdf;jsessionid=DFB03C8F5EE0E813B81A5D-19305B016A?sequence=1
15. Jones R, Stebbing J, Nelson M, et al. Renal dysfunction with ténofovir disoproxil fumarate-containing highly active antiret-roviral therapy regimens is not observed more frequently. Acquir Immune Deficien Synd. 2004;37:1489–95. 10.1097/01.qai.0000138983.45235.02
16. Gallant JE, Staszewski S, Pozniak AL, et al. Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naive patients: A 3-year randomized trial. J Am Med Assoc. 2004;292:191–201. 10.1001/jama.292.2.191
17. Soumana A, Kamaye M, Guero T, Idde I, Souley K. Enfants vivants avec le VIH/SIDA: Aspects épidémiologiques, cliniques et thérapeutiques et évolutifs à l’hôpital National de Lamorde de Niamey. J de la Soc de Biologieclinique du Benin. 2015;023:62–66.
18. Freed EO. HIV-1 replication. Somat. Cell Mol. Genet. 2001;26:13–33. 10.1023/A:1021070512287
19. Frimat C. Dussol B. Adaptation des fonctions rénales à la réduc- tion néphronique anatomiques du glomérule. Physiologie et Physiopathologie Rénales. 2016. Available at: http://cuen.fr/lmd/spip.php?article138
20. Cazenave M, Koehl B, Nochy D, Tharoux PL, Audard V. Atteintesrénales au cours de la drépanocytose. Néphrologie et Thérapeutique. 2013;670:7. 10.1016/j.nephro.2013.07.366
21. Geoffray A, Spehl M, Chami M, Bosson N, Toppet V, Deville A. Imagerie du SIDA chez l’enfant. J de Radiol. 1997;78:1233–43.
22. Chaparro AI, Mitchell CD, Abitbol CL, et al. Proteinuria in chil-dren infected with the human immunodeficiency virus. J Pediatr. 2008;152:844–9. 10.1016/j.jpeds.2007.11.007
23. Ross MJ, Klotman PE. Recent progress in HIV-associated nephropathy. J Am Soc Nephrol. 2002;13:2997–3004. 10.1097/01.ASN.0000040750.40907.99
24. Fine DM, Perazella MA, Lucas GM, Atta MG. Renal disease in patients with HIV infection. Drugs. 2008;68:963–80. 10.2165/00003495-200868070-00006
25. Gupta SK, Eustache JA, Wiston JA, et al. Guidelines for the management of chronic kidney disease in HIV-infected patients: Recommendations of the HIV medicine association of the infectious diseases society of America. Clin Infect Dis. 2005;40:1559–85. 10.1086/430257
26. Tondi M, Diongole H, Abdou I, Toure E, Aboubacar I. Insuffisancerénale chez l’enfantâgé de O à 15 ans au Niger. Néphrologie et Thérapeutique. 2015;11:435. 10.1016/j.nephro.2015.07.211
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.