Prevalence of Microalbuminuria and associated factors among HIV−infected ART naïve patients at Mulago hospital, Kampala, Uganda.

Abstract Background The kidney is one of the common target organs for HIV infection. Early detection of microalbuminuria, the earliest marker of renal damage is critical to slowing down progression to end stage renal disease if appropriate intervention is made. The burden of microalbuminuria and its associated factors in HIV−infected ART naive patients has not been determined in Uganda.Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic on adult HIV−infected ART naïve outpatients. Data was collected on age, sex, level of education, marital status, religion, address, and history of alcohol intake, diabetes mellitus, hypertension, medications and smoking. Measurement of blood pressure, weight and height to determine body mass index (BMI) and investigations including complete blood count (CBC),serum urea and creatinine, Liver function tests(LFTs), CD4+ count, spot morning urine albumin and urine creatinine to determine microalbuminuria were conducted. Logistic regression was used to estimate the strength of association between variables.ResultsA total of 185 adult participants were consecutively enrolled into the study. The mean (SD) age was 34.2(±9.0) years and majority (63.8%) were female. The mean (SD) CD4+ count 466±357 cells/µL, and BMI 23.1 (±4.9) kg/m 2 . The prevalence of microalbuminuria was 18.9%. None of the participants had albuminuria. CD4+ count <350cells/µL and BM1<18.5kg/m 2 were associated increased risk of microalbuminuria OR 3.8 (95%CI 1.7-8.3) (p value=0.01) and OR 4.7 (95%CI 1.82-12.4) (p value=0.03) respectively. Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria.Conclusion Microalbuminuria was highly prevalent in adult HIV−infected ART patients especially those with low CD4+ count and low BMI. There is need to study the effect of ART on microalbuminuria in adult HIV−infected patients. Key words: HIV, microalbuminuria, Uganda, ART naïve