|LETTER TO EDITOR
|Year : 2012 | Volume
| Issue : 1 | Page : 51
Dipstick urinalysis should be documented prior to initiating antiretroviral therapy
Tubonye C Harry
Department of Genitourinary and HIV Medicine, Niger Delta University, College of Health Sciences, Wilberforce Island, Amassoma, Yenagoa, Bayelsa State, Nigeria
|Date of Web Publication||18-Aug-2012|
Tubonye C Harry
Niger Delta University, College of Health Sciences, Wilberforce Island, Amassoma, Yenagoa, Bayelsa State
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Harry TC. Dipstick urinalysis should be documented prior to initiating antiretroviral therapy. Niger Med J 2012;53:51
I read the excellent article by Agbaji et al.  showing the predictors of renal dysfunction in HIV-positive patients initiating therapy with interest. The study highlighted the need of awareness of HIV-associated nephropathy (HIVAN) more common among blacks as a causal factor. Of importance is coinfection with either or both of hepatitis B and C,  increasingly recognized as causal of nephropathy and should therefore be screened at baseline among sub-Saharan African cohort.
A cheap but often neglected baseline investigation before initiating antiretroviral therapy is dipstick urinalysis for evaluation of proteinuria, recommended by most guidelines.  In a recent audit of case-notes in my former department in the United Kingdom  against the British HIV Association (BHIVA) guidelines, this was an area of concern, as less than 33% of our patients had documented dipstick urinalysis in the case-notes before commencement of therapy.
The article by Agbaji et al.  should now focus attention to this problem particularly with the availability of generic Tenofovir; known to be associated with reversible renal dysfunction as shown by Agbaji and others , in sub-Saharan African cohorts. We will advocate documentation of routine urinalysis among other investigations prior to commencement of antiretroviral therapy and when Tenofovir is used 3-monthly serum creatinine with estimation of GFR. Dipstick urinalysis is cheap and universally available and should always be documented before initiating antiretroviral therapy.
| References|| |
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