The Influence of HIV and Schistosomiasis on Renal Function: A Cross-sectional Study among Children at a Hospital in Tanzania
Identifieur interne : 000A03 ( Pmc/Checkpoint ); précédent : 000A02; suivant : 000A04The Influence of HIV and Schistosomiasis on Renal Function: A Cross-sectional Study among Children at a Hospital in Tanzania
Auteurs : Neema M. Kayange ; Luke R. Smart [États-Unis] ; Jennifer A. Downs [États-Unis] ; Mwanaisha Maskini ; Daniel W. Fitzgerald [États-Unis] ; Robert N. Peck [États-Unis]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2015.
Abstract
Schistosomiasis and HIV are both associated with kidney disease. Prevalence and factors associated with abnormal renal function among HIV-infected children in Africa compared to uninfected controls have not been well described in a schistosomiasis endemic area.
This cross-sectional study was conducted at the Sekou Toure Regional Hospital HIV clinic in Mwanza, Tanzania. A total of 122 HIV-infected children and 122 HIV-uninfected siblings were consecutively enrolled. Fresh urine was obtained for measurement of albuminuria and
A high prevalence of renal dysfunction exists among both HIV-infected Tanzanian children and their HIV-uninfected siblings. Schistosomiasis was strongly associated with renal dysfunction.
Url:
DOI: 10.1371/journal.pntd.0003472
PubMed: 25612312
PubMed Central: 4303314
Affiliations:
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Smart</name><affiliation><nlm:aff id="aff001"><addr-line>Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania</addr-line></nlm:aff><wicri:noCountry code="subfield">United Republic of Tanzania</wicri:noCountry></affiliation><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Global Health, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Downs, Jennifer A" sort="Downs, Jennifer A" uniqKey="Downs J" first="Jennifer A." last="Downs">Jennifer A. 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Kayange</name><affiliation><nlm:aff id="aff001"><addr-line>Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania</addr-line></nlm:aff><wicri:noCountry code="subfield">United Republic of Tanzania</wicri:noCountry></affiliation></author><author><name sortKey="Smart, Luke R" sort="Smart, Luke R" uniqKey="Smart L" first="Luke R." last="Smart">Luke R. Smart</name><affiliation><nlm:aff id="aff001"><addr-line>Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania</addr-line></nlm:aff><wicri:noCountry code="subfield">United Republic of Tanzania</wicri:noCountry></affiliation><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Global Health, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Downs, Jennifer A" sort="Downs, Jennifer A" uniqKey="Downs J" first="Jennifer A." last="Downs">Jennifer A. Downs</name><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Global Health, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff003"><addr-line>Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Maskini, Mwanaisha" sort="Maskini, Mwanaisha" uniqKey="Maskini M" first="Mwanaisha" last="Maskini">Mwanaisha Maskini</name><affiliation><nlm:aff id="aff001"><addr-line>Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania</addr-line></nlm:aff><wicri:noCountry code="subfield">United Republic of Tanzania</wicri:noCountry></affiliation></author><author><name sortKey="Fitzgerald, Daniel W" sort="Fitzgerald, Daniel W" uniqKey="Fitzgerald D" first="Daniel W." last="Fitzgerald">Daniel W. Fitzgerald</name><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Global Health, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff003"><addr-line>Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Peck, Robert N" sort="Peck, Robert N" uniqKey="Peck R" first="Robert N." last="Peck">Robert N. Peck</name><affiliation><nlm:aff id="aff001"><addr-line>Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania</addr-line></nlm:aff><wicri:noCountry code="subfield">United Republic of Tanzania</wicri:noCountry></affiliation><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Global Health, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff003"><addr-line>Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><series><title level="j">PLoS Neglected Tropical Diseases</title><idno type="ISSN">1935-2727</idno><idno type="eISSN">1935-2735</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Schistosomiasis and HIV are both associated with kidney disease. Prevalence and factors associated with abnormal renal function among HIV-infected children in Africa compared to uninfected controls have not been well described in a schistosomiasis endemic area.</p></sec><sec><title>Methodology/Principal Findings</title><p>This cross-sectional study was conducted at the Sekou Toure Regional Hospital HIV clinic in Mwanza, Tanzania. A total of 122 HIV-infected children and 122 HIV-uninfected siblings were consecutively enrolled. Fresh urine was obtained for measurement of albuminuria and <italic>Schistosoma</italic> circulating cathodic antigen. Blood was collected for measurement of serum creatinine. Estimated glomerular filtration rate (eGFR) was calculated using the modified Schwartz equation. Renal dysfunction was defined operationally as eGFR<60mL/min/1.73m2 and/or albuminuria>20mg/L in a single sample. Among 122 HIV-infected children, 61/122 (50.0%) met our criteria for renal dysfunction: 54/122 (44.3%) had albuminuria>20mg/L and 9/122 (7.4%) had eGFR<60. Among 122 HIV-uninfected children, 51/122 (41.8%) met our criteria for renal dysfunction: 48/122 (39.3%) had albuminuria>20mg/L and 6/122 (4.9%) had eGFR<60. Schistosomiasis was the only factor significantly associated with renal dysfunction by multivariable logistic regression (OR = 2.51, 95% CI 1.46–4.31, p = 0.001).</p></sec><sec><title>Conclusions/Significance</title><p>A high prevalence of renal dysfunction exists among both HIV-infected Tanzanian children and their HIV-uninfected siblings. Schistosomiasis was strongly associated with renal dysfunction.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Choi, Ai" uniqKey="Choi A">AI Choi</name></author><author><name sortKey="O Are, A" uniqKey="O Are A">A O’Hare</name></author><author><name sortKey="Rodriguez, R" uniqKey="Rodriguez R">R Rodriguez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fabian, J" uniqKey="Fabian J">J Fabian</name></author><author><name sortKey="Naicker, S" uniqKey="Naicker S">S Naicker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Msango, L" uniqKey="Msango L">L Msango</name></author><author><name sortKey="Downs, Ja" uniqKey="Downs J">JA Downs</name></author><author><name sortKey="Kalluvya, Se" uniqKey="Kalluvya S">SE Kalluvya</name></author><author><name sortKey="Kidenya, Br" uniqKey="Kidenya B">BR 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS Negl Trop Dis</journal-id><journal-id journal-id-type="iso-abbrev">PLoS Negl Trop Dis</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosntds</journal-id><journal-title-group><journal-title>PLoS Neglected Tropical Diseases</journal-title></journal-title-group><issn pub-type="ppub">1935-2727</issn><issn pub-type="epub">1935-2735</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25612312</article-id><article-id pub-id-type="pmc">4303314</article-id><article-id pub-id-type="publisher-id">PNTD-D-14-01126</article-id><article-id pub-id-type="doi">10.1371/journal.pntd.0003472</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>The Influence of HIV and Schistosomiasis on Renal Function: A Cross-sectional Study among Children at a Hospital in Tanzania</article-title><alt-title alt-title-type="running-head">Schistosomiasis, HIV and Renal Function in Children</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kayange</surname><given-names>Neema M.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="corresp" rid="cor001">*</xref></contrib><contrib contrib-type="author"><name><surname>Smart</surname><given-names>Luke R.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Downs</surname><given-names>Jennifer A.</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Maskini</surname><given-names>Mwanaisha</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Fitzgerald</surname><given-names>Daniel W.</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Peck</surname><given-names>Robert N.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="aff" rid="aff002"><sup>2</sup></xref><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania</addr-line></aff><aff id="aff002"><label>2</label><addr-line>Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America</addr-line></aff><aff id="aff003"><label>3</label><addr-line>Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Bentwich</surname><given-names>Zvi</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Rosetta Genomics, ISRAEL</addr-line></aff><author-notes><fn fn-type="COI-statement" id="coi001"><p>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: NMK RNP DWF. Performed the experiments: NMK MM. Analyzed the data: NMK RNP LRS JAD. Contributed reagents/materials/analysis tools: DWF JAD RNP NMK. Wrote the paper: NMK LRS MM JAD RNP DWF.</p></fn><corresp id="cor001">* E-mail: <email>neemakayange@gmail.com</email></corresp></author-notes><pub-date pub-type="collection"><month>1</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>22</day><month>1</month><year>2015</year></pub-date><volume>9</volume><issue>1</issue><elocation-id>e0003472</elocation-id><history><date date-type="received"><day>4</day><month>7</month><year>2014</year></date><date date-type="accepted"><day>12</day><month>12</month><year>2014</year></date></history><permissions><copyright-statement>© 2015 Kayange et al</copyright-statement><copyright-year>2015</copyright-year><copyright-holder>Kayange et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="pntd.0003472.pdf"></self-uri><abstract><sec><title>Background</title><p>Schistosomiasis and HIV are both associated with kidney disease. Prevalence and factors associated with abnormal renal function among HIV-infected children in Africa compared to uninfected controls have not been well described in a schistosomiasis endemic area.</p></sec><sec><title>Methodology/Principal Findings</title><p>This cross-sectional study was conducted at the Sekou Toure Regional Hospital HIV clinic in Mwanza, Tanzania. A total of 122 HIV-infected children and 122 HIV-uninfected siblings were consecutively enrolled. Fresh urine was obtained for measurement of albuminuria and <italic>Schistosoma</italic> circulating cathodic antigen. Blood was collected for measurement of serum creatinine. Estimated glomerular filtration rate (eGFR) was calculated using the modified Schwartz equation. Renal dysfunction was defined operationally as eGFR<60mL/min/1.73m2 and/or albuminuria>20mg/L in a single sample. Among 122 HIV-infected children, 61/122 (50.0%) met our criteria for renal dysfunction: 54/122 (44.3%) had albuminuria>20mg/L and 9/122 (7.4%) had eGFR<60. Among 122 HIV-uninfected children, 51/122 (41.8%) met our criteria for renal dysfunction: 48/122 (39.3%) had albuminuria>20mg/L and 6/122 (4.9%) had eGFR<60. Schistosomiasis was the only factor significantly associated with renal dysfunction by multivariable logistic regression (OR = 2.51, 95% CI 1.46–4.31, p = 0.001).</p></sec><sec><title>Conclusions/Significance</title><p>A high prevalence of renal dysfunction exists among both HIV-infected Tanzanian children and their HIV-uninfected siblings. Schistosomiasis was strongly associated with renal dysfunction.</p></sec></abstract><abstract abstract-type="summary"><title>Author Summary</title><p>Ninety percent of schistosomiasis occurs in sub-Saharan Africa, where 91% of HIV-infected children reside. Both schistosomiasis and HIV affect the kidney, but their respective effects on kidney disease in children are not well described. Our prior work in HIV-infected adults demonstrated a high prevalence of kidney disease, possibly worsened by schistosomiasis, but adults are less commonly and less heavily infected with schistosomiasis than children. Therefore, we sought to describe the prevalence and factors associated with renal dysfunction (defined operationally as eGFR <60mL/min/1.73m<sup>2</sup> and/or albuminuria >20mg/L in a single urine test) among HIV-infected children and their uninfected siblings living in a schistosomiasis endemic area. We found that half of HIV-infected children and more than one third of HIV-uninfected children had renal dysfunction. Schistosomiasis was the only factor significantly associated with renal dysfunction, increasing odds of renal dysfunction by 2.5-fold. Nearly 50% of the renal dysfunction we observed in both groups could be explained by schistosomiasis. The strong association between schistosomiasis and renal dysfunction among both HIV-infected and uninfected children should remind clinicians to screen for schistosomiasis. It also ought to spur further prospective research to assess for causality and outcomes in the relationship between <italic>S. mansoni</italic> and kidney disease in children.</p></abstract><funding-group><funding-statement>This project was supported in part by grants from the United States National Institute of Health/National Institute of Allergy and Infectious Diseases (AI098627), the National Institutes of Health Fogarty International Center (R25TW009337) and a United States Agency for International Development (USAID) leadership training program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript</funding-statement></funding-group><counts><fig-count count="0"></fig-count><table-count count="4"></table-count><page-count count="13"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>All relevant data are within the paper and its Supporting Information files.</p></notes></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>État de New York</li></region></list><tree><noCountry><name sortKey="Kayange, Neema M" sort="Kayange, Neema M" uniqKey="Kayange N" first="Neema M." last="Kayange">Neema M. Kayange</name><name sortKey="Maskini, Mwanaisha" sort="Maskini, Mwanaisha" uniqKey="Maskini M" first="Mwanaisha" last="Maskini">Mwanaisha Maskini</name></noCountry><country name="États-Unis"><region name="État de New York"><name sortKey="Smart, Luke R" sort="Smart, Luke R" uniqKey="Smart L" first="Luke R." last="Smart">Luke R. Smart</name></region><name sortKey="Downs, Jennifer A" sort="Downs, Jennifer A" uniqKey="Downs J" first="Jennifer A." last="Downs">Jennifer A. Downs</name><name sortKey="Downs, Jennifer A" sort="Downs, Jennifer A" uniqKey="Downs J" first="Jennifer A." last="Downs">Jennifer A. Downs</name><name sortKey="Fitzgerald, Daniel W" sort="Fitzgerald, Daniel W" uniqKey="Fitzgerald D" first="Daniel W." last="Fitzgerald">Daniel W. Fitzgerald</name><name sortKey="Fitzgerald, Daniel W" sort="Fitzgerald, Daniel W" uniqKey="Fitzgerald D" first="Daniel W." last="Fitzgerald">Daniel W. Fitzgerald</name><name sortKey="Peck, Robert N" sort="Peck, Robert N" uniqKey="Peck R" first="Robert N." last="Peck">Robert N. Peck</name><name sortKey="Peck, Robert N" sort="Peck, Robert N" uniqKey="Peck R" first="Robert N." last="Peck">Robert N. Peck</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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