Prevalence and Patterns of Urinalysis Abnormalities in HIV Patients on Highly Active Antiretroviral Therapy in a Tertiary Hospital in Calabar, South-South Nigeria
Henry Ohem Okpa *
Department of Internal Medicine, University of Calabar, Calabar, Nigeria and Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Elvis Mbu Bisong
Department of Family Medicine, University of Calabar, Calabar, Nigeria and Department of Family Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Patrick Ntui Mbu
Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Daniel Emmanuel Otokpa
Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Edadi Ekup Ukam
Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Urinalysis is a useful screening tool that provides a simple, cost-effective, and non-invasive method for assessing kidney function and early detection of kidney involvement in HIV patients with or without antiretroviral therapy. The use of highly active antiretroviral therapy (HAART) is associated with urinalysis abnormalities which may precede deterioration in renal function.
Aim: The main objective of this study is to determine urinalysis abnormalities in HIV-infected patients on highly active antiretroviral therapy (HAART) using the urine dipstick, which is a simple diagnostic tool.
Methods: A hospital-based cross-sectional study was conducted among 131 adult HIV-infected patients on antiretroviral therapy (ART) attending clinic at the University of Calabar Teaching Hospital. Participants were recruited in a consecutive fashion and data were collected using standard structure questionnaire, including clinical and laboratory investigations. Urinary dipstick tests were performed using combur 10 test strips ((Roche Diagnostics GmbH, Mannheim, Germany) on the freshly collected urine samples from the participants. Data were analyzed using descriptive statistics, chi-square test; student t-test and binary logistic regression analysis. P < .05 was accepted to be significant.
Results: In the 131 HIV-infected patients studied, 75.6% were females, majority (80.2%) were on tenofovir based regimens, the mean age was 43.2±9.6 years and 37.4% had urinalysis abnormalities. The specific urinalysis abnormalities were proteinuria (32.1%), leukocyturia (21.4%), and haematuria (7.6%). Urinalysis abnormalities including proteinuria and leukocyturia were associated with older age (51.5±6.2 years, 50.0±7.4 years, P = .0001) and lower CD4 cell count (260.5±107.3µ/L, 270.2±117.3µ/L, P = .0001), but haematuria was associated with shorter duration of HIV (3.1±2.9 years, P = .003). Moreso, increasing age (CI 1.092-1.261, P = .0001), female gender (CI 0.080-0.976, P = .046), and lower CD4 cell count (CI 0.989-0.996, P = .0001) predicted urinalysis abnormalities.
Conclusion: Urinalysis abnormalities was prevalent in HIV-infected patients on HAART and the associated risk factors were older age and lower CD4 cell count. Furthermore, urinalysis abnormalities was predicted by increasing age, female gender, and lower CD4 cell count.
Keywords: Abnormalities, highly active antiretroviral therapy, HIV, renal dysfunction, urinalysis