ELECTROLYTE ABNORMALITIES IN HIV INFECTED CHILDREN IN CALABAR, NIGERIA.
Formerly Published in Vol. 5 No. 8 Jan. - Jun., 2020
Keywords:
Electrolytes abnormalities, HIV, HAART, Renal diseaseAbstract
Background: HIV infected patients and particularly those with AIDS are predisposed to a host of different water, electrolytes and acid base disorders. Electrolytes and acid-base disorders have been reported in patients with HIV/AIDS with or without treatment. This study was aimed at determining the prevalence of electrolytes abnormalities in HIV infected children in Calabar, Nigeria.
Subjects and methods: A descriptive cross sectional study of 146 consecutive HIV infected children seen at the paediatric HIV clinics of General Hospital Calabar and University of Calabar Teaching Hospital, aged 6 weeks to 15 years, carried out from 1st February to 30th September, 2015. Demographic and clinical data were obtained by interviewing parents/guardians of each subject, who met the inclusion criteria such as treatment with or without highly active antiretroviral therapy (HAART) including Zidovudine and Stavudine. Children who had vomiting and diarrhoea were excluded. Clinical examinations, anthropometry were done and blood samples taken for serum electrolytes (Potassium, Sodium and bicarbonate). Serum electrolytes were analyzed using ion selective electrode spectrophotometry. In this study, electrolyte abnormalities were dened as thus: Hypernatraemia (Serum Sodium level> 150mEq/L), hyponatraemia (Serum Sodium level <130mEq/ ), hyperkalaemia (Serum Potassium > 5.5mEq/L), hypokalaemia (Serum Potassium < 3.5mEq/L) and metabolic acidosis (Serum bicarbonate < 20mEq/L). Data were analysed using SPSS version 20 and p-value ≤0.05 was signicant.
Results: Out of the 146 children recruited, 85 (58.2%) were males giving a male: female ratio of 1:0.7. The mean age was 100.8±45.3 months and most 104 (71.2%) were in the age group 5-14 years. Majority, 119 (81.5%) of children were on HAART and 133 (91%) had vertical transmission from mother-to-child transmission. Most subjects had non-advanced diseases and 85(58.2%) were in middle social class. Electrolytes disorder showed one (0.7%) subject with hyponatraemia, one (0.7%) with hypernatraemia and 3(2.2%) with hyperkalaemia and no subject had hypokalaemia, while 21.9% had low serum bicarbonate (metabolic acidosis). There was no relationship between acidosis and drugs taken as well as the CD4 counts (P>0.05).
Conclusion: Metabolic acidosis was the commonest electrolyte abnormality seen in HIV infected children especially those on HAART containing Zidovudine and Stavudine. Routine electrolyte estimation should be done in children with HIV/AIDS to prevent progress to severe renal disease.
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1. UNAID fact sheet Nov. 2016. www.unaid. org/En/resources/Factsheet. Accessed 10th May, 2016. UNAIDS/NIG HIV AND AIDS estimate 2015 Available www.unaid.org/ EN/ regioncountries /Nigeria. Accessed 5th May, 2016 Nachman SA, Van Dyke RB, Gona P. Incidence of non-infectious complication in perinatally acquired HIV infected children and adolescent in the HAART era. In: 42 nd Annual meeting of the Infectious Disease Society of America 2004. Boston M. A. abstract 95 Musso CG, Belloso WH, Glassock RJ. Water, electrolyte and acid- ase alteration in HIV infected patient. World J Nephrol. 2016. 6; 5 (1): 33 – 42 Tang WW, Kaptein EM, Feinstein EI, Massry SG. Hyponatraemia in hospitalized patients with Acquired Immunodeciency Syndrome (AIDS) and AIDS related complex Am J Med. 1993; 94: 169 – 74. Glassock RJ. Cohen AJ, Donovitch G, Parsa KP, HIV and the kidney. Ann Intern Med. 1990; 112 – 115. Agarwu A, Soni A, Gechanowsky M, Chander P, Trese G. Hyponatraemia in patients with AIDS. Nephron 1989, 53: 317 – 321 Peters SA. Electrolytes disorder and renal Pioneer Medical Journal Vol. 5, No. 8, JANUARY - JUNE, 2020 31 dysfunction in acquired immuno deciency syndrome patients. J Nat Med Assoc. 1991; 33 889 – 890. 9. Laniado – Laborin R, Cabralos – Vargas MN. Amphotericin B side effect and toxicity.Revista Iberoamericana de Micologia. 2009; 26: 223 – 227. 10. Greenberg S, Reiser IW, Chou SY Hyperkalaemia with high dose trimethoprim sulfamethoxazole therapy. Am J kidney Dis. 1993; 22: 603 – 606 11. Salifu M. Misra N. HIV associated nephropathy. Medscape: 2015. Available http://emedicine.com/article 2460 12. Peter SA. The incidence of abnormal calcium level in patients with AIDS. J Nat. Med Assoc 1992; 84:626-628. 13. Verma B, Singh A. Clinical Spectrum of renal disease in hospitalized HIV/AIDS patients-A teaching hospital experience. J Family Med Prim Care 2019; 8: 8886 – 91. 14. Braconnier Philippe, Delforge Marc, Garjau Maria, Karl Martin Wissing, Stephane De Wit. Hyponatriaemia is a maker of disease severity in HIV infected patients: a retrospective cohort study. BMI Infect Dis. 2017;17(98): https:// doi.org/ 10.1186/ s12 879-017-2191-515. Olusanya O, Okpere E, Ezimokhai M. The importance of social class in voluntary fertility control in a developing country. W Afr J Med. 1985; 4:205 – 212 16. W H O c a s e d e n i t i o n o f H I V f o r surveillance and Revised clinical staging and Immunological Classication of HIV related disease in adult and children. WHO 2007 PP11-15@who.int. Accessed date Sept.7, 2018. 17. World Health Organisation (2007) The WHO child growth standard. Growth reference 5-9yrs 2007. Geneva Switzerland who available from http//: www.who.int /childgrowthref/en. Accessed 23 April, 2017 18. Federal Ministry of Health: Integrated ational Guidelines for Paediatric HIV and AIDS treatment and care in Nigeria, Abuja, Nigeria. 2011. Page 21 19. Tolaymat A. AL – Mousilly F, Sleasman J. aryani S, Nelberger R. Hyponatraemia inpaediatric patients with HIV infection. South Med J. 1995; 88 (10): 1039 – 10142 20. Nilima KR, Gafencu M, Doro G, Thanks CN, Lesovia M, Serban M. Renal consequences in HIV infected children in Romania. JURNALUL PEDIATRULUI. 2009; 12: 45 – 46. 21. Nelson M,zwa A, Sokwala A, Harama RS. Stebbing J. Faconi Syndrone and Lachc acidosis associated with stavudine and lamivudine therapy.AIDS 2008;22:1374 – 1376. 22. Agarwal A, al – Talib K, Alabrash M. Type b lactic acidosis in an AIDS patient treated with Zidovudine. MD Med J. 1996; 45:929 – 931. 23. Boubaker K, Flepp M, Sudre P.et al. yperlactaemia and Antiretroviral therapy. The Swiss HIV cohorts study. Clin Infect Dis 2001; 33:1931-37. 24. Coghlan ME, Sommadossi JP, Jhala NC, Many WJ, Saag MS, Johnson VA. Symptomatic lactic acidosis in hospitalised Antiretroviral treated patients with human immunodeciency virus infection: a report of 12 cases. Clin Infect Dis 2001; 33 (11) :1944-21. 25. Moyle GJ, Datta D , Mandalia S , Morlese J, Asboe D, Gazzard BG. Hyperlactaemia and lactic acidosis during antiretroviral therapy:relevance, reproducibility and ossible risk factors. AIDS 2002;16:1341-49. 26. Bonnet F, Bonarche M, Morlet P et al. Risk factorsfor lactic acidosis in HIV infectedpatients treated with nucleotide reverse transcripts inhibitors; a case control study. lin Infect Dis 2003; 36:324-28.27. Geddes R, Knight S, Moosa M, Reddi A, Uebel K, Sunpath H. A high incidence of nucleotide reverse transcriptase inhibitors induced lactic acidosis in HIV infected patients in South Africa context. South Afr Med J. 2006; 96:8.
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