Urine albumin and serum cystatin C in HIV-infected children on antiretroviral drugs: A cross-sectional hospital based study

Abstract

Objectives Kidney diseases are known complications of human immunodeficiency (HIV) despite administration of antiretroviral drugs. There is limited information on early markers of renal glomerular functions among Nigerian children on highly active antiretroviral therapy (HAART). Urine albumin and serum cystatin C are sensitive indicators of renal dysfunction, and their timely detection could potentially prevent the progression of overt chronic kidney disease in this vulnerable population.To assess the renal glomerular functions using urine albumin–creatinine ratio and blood level of cystatin C in children living with HIV on HAART. Material and Methods This descriptive cross-sectional study involved 100 participants; the case group comprised 50 confirmed HIV-infected children, while the control participants were age- and sex-matched 50 HIV-negative children. The data analysis was done using the statistical packages for Social Science version 20.0 Results The mean level of serum cystatin C among the HIV-positive subjects (0.57 ± 0.11 mg/L) was not statistically significant (P = 0.332) relative to the control (0.59 ± 0.11 mg/L). None of the HIV-infected and control subjects had abnormal concentrations of cystatin C nor its estimated glomerular filtration rate. Microalbuminuria was found in 16.0 and 8.0% of the recruited HIV-infected and control subjects, respectively. Only prolonged duration of HIV/AIDS was significantly associated with microalbuminuria, while other parameters such as World Health Organization (WHO) clinical staging, cluster of differentiation (CD)-4 cell count, and classes of HAART were not predictive of albuminuria. Conclusion The study showed that albuminuria was high among HIV-infected children on HAART, despite their normal serum levels of cystatin C and estimated glomerular filtration rate (GFR). A prolonged duration of HIV/AIDS was associated with the occurrence of microalbuminuria, which could be an early indicator of subclinical kidney impairment among HIV-infected subjects. The findings of this study indicate a high risk of cardiorenal complications among HIV-infected children on HAART. Consequently, regular renal and cardiovascular assessments are necessary for this vulnerable population to mitigate potential morbidity and mortality. However, further research is warranted to elucidate the pathogenesis, progression, and long-term outcomes of individuals with this finding.