C-Reactive Protein Levels and Hypertension in HIV Infected Children on Highly Anti-retroviral Therapy at the University of Abuja Teaching Hospital, Gwagwalada, Nigeria

Abstract

Aim: To evaluate C-reactive protein levels in stable HIV positive children and adolescents on anti-retroviral therapy overtime in our health facility, and relate the findings to their CD4, viral-load, and blood pressure. Study Design: A cross-sectional hospital-based survey. Place and Duration of Study: At Paediatric Out-patient Special Treatment Clinic of University of Abuja Teaching Hospital, Gwagwalada over a six-month period. Methodology: The subjects were consecutively enrolled until the required sample size was met. Data entry and analysis was with SPSS version 23 computer software. Sample: We included 126 (66 males and 60 females) subjects. Their biodata, weight, length/height, body-mass-index, blood pressure, CD4 cell count, viral-load, and C-reactive proteins were measured. Results: Their mean age was 14.1±3.1 [7, 18] years, and most 69(54.8%) were 15-18 years. Majority 73(57.9%) had body-mass-index of <18 kg/m, many 99(78.6%) had vertical transmission, 82(65.1%) were from low socio-economic background, while most 104(82.5%) were on 2nd line medications. Their mean duration on anti-retroviral-therapy, CD4-cell-count, viral-load, and C-reactive-protein at enrollment were 7.2±2.9 [1, 16] years, 792.11±37.8 cells/mm3, 1203.5±155.4 copies/ml, and 9.9±2.7mg/l respectively. 101 (88.1%) of the recruited subjects had normal/minor elevation of CRP of <10mg/ml, while 15 (11.9%) had moderate elevation of 10-100mg/ml. None had marked or severe elevation. The prevalence of hypertension was 10(7.9%) with diastolic form 7(5.6%) being commoner than systolic 3(2.4%). Multivariate analysis showed significant association between C-reactive-protein with CD4-cell-count [OR, 0.11 (CI, 0.008-1.029, P=.006)], systolic-blood-pressure [OR, 0.26 (CI, 0.81-2.97, P=.026)], and diastolic-blood-pressure [OR, 0.10, (CI, 0.14 (0.35-3.59), P=.013)]. Conclusion: There is high prevalence of hypertension among stable HIV positive children and adolescent on highly active antiretroviral therapy overtime in our center. C reactive protein can be used to monitor risk of development of hypertension in these subjects.