Available online Aug 21, 2025.

[ Original ] Volume 31, Issue 4, 2025, Pages 729-734

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Abstract

 

Human immunodeficiency virus (HIV) among children has been on the rise due to increased vertical transmission and socioeconomic factors. Antiretroviral therapy (ART) has been effectively used in treatment among adults and children living with HIV (CLHIV), and urinalysis is used for routine screening for kidney health. However, there is limited study on urine cytological findings among HIV-seropositive children on ART in sub-Saharan Africa. The objectives of this study were to investigate the effects of ART on the urinary system of HIV-seropositive children by screening their urine for abnormal chemical constituents and atypical cytological epithelial cell changes. Following administration of questionnaire, freshly voided urine samples were collected from 88 participants on ART attending the Paediatric HIV Clinic of General Hospital, Calabar, Nigeria.  Urinalysis was carried out using Meditest Combi-9 strips. For microscopic cytological evaluation, urine smears made from centrifuged sediments were fixed in 95% ethanol and stained with Papanicolaou technique. Age distribution showed 30 (34.1%), 44 (50%), and 14 (16.9%) of the participants were of the age range of 0-4 years, 5-9 years, and 10-14 years respectively. Based on the duration of ART administration, <1 month had 20 (22.7%), 1-6 months had 44 (50%), and >6 months had 24 (27.3%) participants. Proteinuria was reported in 36 (40.9%) of the participants. The cytological findings revealed that 46 (52.3%) had normal epithelial cells, 20 (22.7%) showed degenerative epithelial changes and 22 (25%) had squamous metaplasia. A total of 18 (20.5%) participants had crystals in their urine. In overall, the duration of use of ART was associated with proteinuria (p=<0.001), increased degenerative and metaplastic epithelial changes (p=<0.001), and crystalluria (p=0.002). In conclusion, long-term ART use may predispose to atypical cytological changes associated with degeneration, squamous metaplasia, and presence of crystalluria in HIV-seropositive children. There is need to include urine cytology examination as routine screening test for CLHIV on antiretroviral therapy.  

 

Keywords

Human Immunodeficiency Virus, Urine Cytology, Children, Antiretroviral therapy, Proteinuria, Calabar,

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