Microalbuminuria among HIV/AIDS patients in Africa: a systematic review and meta-analysis

BACKGROUND: Over the past decade, the incidence of chronic kidney disease among HIV-seropositive people has increased at an alarming rate. Microalbuminuria is believed to be a precursor of HIV-related renal disease; early detection with intervention may prevent end-stage renal disease. Therefore, the current study was aimed at determining the pooled prevalence of microalbuminuria among HIV patients in Africa. METHODS: We accessed Google Scholar, PubMed, the Cochrane Library, EMBASE, the Web of Science, ScienceDirect, and ResearchGate to get the original research articles. We employed the IAý and Cochran’s Q test to assess the presence of heterogeneity between studies. Publication bias was checked by using a funnel plot and Egger’s regression test. The pooled prevalence was estimated using the random-effects model. We ran the sensitivity analysis to see if there were outlier results in the included studies. Moreover, subgroup analysis was also done. RESULTS: The current meta-analysis includes 16 studies with 3588 individuals. In Africa, the overall pooled prevalence of microalbuminuria in both adults and children was 22.25% (95% CI 17.38-27.13; I(2)ƒ_%=ƒ_%92.6). Microalbuminuria was observed to be 23.32% (95% CI: 17.36-29.29) in adult study groups and 20.72% (95% CI: 11.85-29.56) in children. Female HIV/AIDS patients exhibited a higher pooled prevalence of microalbuminuria (22.68% (95% CI: 7.43-37.94)) than male HIV/AIDS patients (15.84% (95% CI: 7.28-24.39)). Furthermore, the overall estimates of microalbuminuria among ART users and non-users were 22.32% (95% CI: 13.00-31.63) and 19.41% (95% CI: 14.88-23.94), respectively. CONCLUSION: The present review study found that over one-fourth of HIV-infected patients had microalbuminuria, indicating a considerable burden of subclinical kidney disease. Therefore, HIV patients need to be screened early for microalbuminuria to prevent further renal complications. PROTOCOL REGISTRATION: It has been registered in the PROSPERO database with a registration number of CRD42023446664. CLINICAL TRIAL NUMBER: Not applicable

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • General HIV+ population
• Co-morbidities
  • Other
• Health Systems
  • Governance arrangements