Prévalence de la maladie rénale chez les enfants infectés par le VIH-1 au KNH, Nairobi
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Soixante pour cent des patients atteints du VIH/SIDA développent une forme ou une autre de pathologie rénale. La protéinurie peut être la première manifestation clinique de la néphropathie liée au VIH. Nous avons mené une enquête transversale auprès d'enfants infectés par le VIH afin de déterminer la prévalence des maladies rénales. Au total, 87 sujets ont été recrutés. Quarante-six (52,8 %) étaient des filles et 41 (47,1 %) des garçons. Leur âge allait de 18 mois à 13 ans, avec un âge médian de 60 mois. Dans l'ensemble, 35,6 % des patients présentaient des signes de néphropathie en raison de la présence d'une protéinurie persistante et/ou d'un débit de filtration glomérulaire anormal. Une protéinurie a été constatée chez 28 (32,2 %) des sujets et une protéinurie persistante chez 14 (16,1 %) d'entre eux. Quarante-quatre (50,6 %) des sujets étaient au stade clinique 3 de la maladie, 17 (19,5 %) au stade 2, 14 (16,1 %) au stade 4 et 12 (13,8 %) au stade 1. Seize (18,4 %) des sujets de l'étude n'étaient pas immunodéprimés (CD4 > 25 %), 19 (21,8 %) étaient modérément immunodéprimés et 52 (59,8 %) étaient gravement immunodéprimés. Un tiers des enfants infectés par le VIH souffraient d'une forme ou d'une autre de maladie rénale. Dans cette étude, la protéinurie persistante était plus fréquente chez les enfants au stade clinique précoce du VIH/SIDA.
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