Renal Data from Asia – Africa: Renal function, urinalysis abnormalities and correlates among HIV-infected Cameroonians naive to antiretroviral therapy

As per guidelines and recommendations,screening for renal diseases should be performed at the time of diagnosis of human immuno-deficiency virus (HIV) infection; however,this remains largely unimplemented in many settings across Sub-Saharan Africa. We evaluated the renal function, urinalysis abnormalities and their correlates in HIV-infected individuals who were naïve to highly active antiretroviral therapy (HAART). This was a cross-sectional study of 2 months duration involving 104 HIV-infected outpatients naive to HAART (71 women,68%) attending the HIV clinic of the Yaoundé General Hospital in Cameroon. Renal and urinalysis parameters were measured and the Student t-test and Fischer exact test were used to compare the groups of participants. The mean age and CD4 count were,respectively,35 ± 10.7 years and 305 ± 202/mL. Fifty-six (54%) patients presented with stages 3 and 4 of HIV infection. Forty-three (41%) patients had urinalysis abnormalities,including proteinuria (36%),leukocyturia (13%) and hematuria (12%). Proteinuria was associated with increased age,advanced stage of HIV infection,decreased CD4 count,hematuria and renal failure (P 0.04). Hematuria and leukocyturia were associated with decreased CD4 count and advanced stage of HIV infection,respectively (P = 0.04). The mean estimated glomerular filtration (eGFR) rate was 100.2 ± 32.7 mL/min; three (3%) patients had renal failure (eGFR 60 mL/min) and 45 (43%) patients had reduced kidney function 60 ≤eGFR ≤90 mL/min. There was a high prevalence of decreased kidney function and proteinuria among Cameroonian HIV-infected patients naïve to HAART. Indicators of the severity of HIV infection,including advanced stage and low CD4 count,were associated with urinalysis abnormalities.