: MICRO- AND MACRO-ALBUMINURIA IN HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENTS BEFORE COMMENCEMENT OF HIGHLY ACTIVE ANTI-RETROVIRAL TREATMENT

Abstract

Background: The brunt of the Human Immunodeficiency Virus infection (HIV)/the Acquired Immunodeficiency Syndrome (AIDS) is largely borne by communities in sub-Saharan Africa. The study describes urinary albumin excretion (UAE) in Nigerians with the HIV infection.
Methods: Consecutive patients with HIV infection were seen in the HIV counseling and testing (HCT) unit of the Faith Alive Foundation Hospital, Jos, and a similar group of healthy uninfected controls were evaluated for renal disease.
Results: Of the 200 patients with HIV infection and 100 uninfected controls studied, increased urinary albumin excretion (UAE) was present in 39(19.5%) of the Subjects and 5.0(5.0%) of Controls. The difference between the mean values for the urinary albumin excretion for both Subjects and Controls [182.3+54.3 and 163.9+39.3mg/l respectively (p=0.006)] was statistically significant.
The difference between the mean urinary albumin/creatinine ratio for both Subjects and Controls [1.8+1.2mg/mmol and 1.4+0.4mg/mmol respectively (p=0.001)] was statistically significant. . The CD4+ cell count was found to be significantly lower in subjects with increase urinary albumin excretion compared to those with values within the reference interval.
Conclusion/Recommendation: UAE is a common complication of HIV infection due to a number of factors other than Highly Active Anti-Retroviral therapy (HAART). Early screening for renal disease using microalbuminuria and the use of medications such as angiotensin converting enzyme inhibitors could help reverse progression to end stage renal disease.