Renal disease in HIV infected Nigerian Children coinfected with hepatitis B and C

Abstract

HIV, HBV and HCV are known to individually cause chronic glomerulopathies. This cross sectional study 
was carried out to identify renal disease and the risk of developing renal disease in HIV/Hepatitis B and C 
co-infected Nigerian children aged 10 months to 17 years. Each child was tested for hepatitis B surface 
antigen, antibody to hepatitis B core antigen and antibody to hepatitis C virus. Serum creatinine levels were 
determined and used in calculating the glomerular filtration rate. Urine was tested for proteinuria and 
microalbuminuria. Renal disease was defined as presence of proteinuria of ≥1+ on dipstick with or without 
GFR <60 ml/ min/1.73 m2.  Renal disease risk was defined as presence of microalbuminuria of ≥20mg/l. Of 
the 114 HIV infected children HIV/HBV coinfection was observed in 10(8.8%) and HIV/HCV coinfection in 
7(7%). All HIV/HBV coinfected children had risk of renal disease 6(60%) or established renal disease 4(40%). 
Two HIV/HCV coinfected children had risk of renal disease while 1 had established renal disease. The mean 
CD4 count 497±333.5 in HIV/HBV coinfected children with renal disease was significantly lower than the 
1222.6±400.6 in HIV monoinfected children with renal disease p<0.01. HIV/HBV coinfected children with 
renal disease were more likely to be unimmunized compared to HIV monoinfected children with renal 
disease. P= 0.02. We conclude that renal disease was common in HIV/HBV coinfected children and this was 
associated with being unimmunized against hepatitis B.