Preliminary study on screening for proteinuria using urine test strips in patients living with HIV at Fann's CHNU in Dakar

Résumé

Glomerulopathy and other kidney disorders are frequent during the natural history of HIV infection even if their incidence decreased with HAART. They are almost always responsible of proteinuria and/or hematuria. We have conducted a preliminary study on the prevalence of proteinuria screened by urinary strip in PLWHIV followed up at the clinic of infectious diseases at Fann teaching hospital in Dakar. It was a prospective study from August 1^st to October 30^th, 2008. We enrolled all patients both indoor and outdoor positive for HIV presenting a proteinuria without concurrent urinary infection. We collected sociodemographic data, natural history, factors related to proteinuria and nephropathy. Data entering and analysis were done using Epi Info version 6.04 software. We have used Chi square test to compare qualitative variables and p<0.05 was set as significant threshold. A total of 100 patients were enrolled, the mean age was 43± 9.8 y/o in male and 39± 10 y/o in female. Females were predominant (sex ratio M/F is 0.5). All patients were infected by HIV1, they have been diagnosed at a late stage of immunodeficiency, fifty percent was taking HAART, and the majority using AZT +3TC+ EFV regimen. The prevalence of proteinuria was 47.0%. Factors significantly associated with proteinuria were : the gender ; CD4 count <350/mm³ ; viral load > 100000copies/mm³ ; BMI < 18.5kg/m² ; Hemoglobin level < 8.5 g/dl, chemoprophylaxis with Cotrimoxazole  and WHO clinical stage 3 and 4. The frequency of nephropathy during HIV infection in infectious diseases ward of Fann in Dakar suggest to include screening with urinary strip in the initial and follow up checking of all patient infected by HIV. And in all cases favoring factors of this nephropathy should be corrected. Kidney biopsy could help for better studies.