Urinary tract infection among asymptomatic HIV patients in Benin City, Nigeria

The impact of human immunodeficiency virus (HIV) infection and CD4+ count on the prevalence of urinary tract infection (UTI) is studied to determine the prevalence of UTI among HIV and non-HIV subjects. Clean-catch midstream urine and venous blood was collected from 421 subjects comprising 317 HIV patients (89 men, 228 women) and 104 non-HIV subjects (48 men, 56 women). The HIV patients consisted of 101 highly active antiretroviral therapy (HAART)-naive subjects and 216 patients on HAART for three to six months. The HIV patients were asymptomatic and all subjects had no signs or symptom of UTI. Microbial isolates were identified in urine and susceptibility tests were performed. Only HIV patients on HAART had significantly higher prevalence of asymptomatic UTI compared with non-HIV subjects (27.78% vs. 17.31%, OR = 1.8376, 95% confidence interval = 1.0198-3.3112, P = 0.0411). Among both groups, CD4+ count < 200 cells/microL was not associated with asymptomatic UTI. Staphylococcus aureus was the most common uropathogen (27.2%) and nitrofurantoin was the most active antibacterial agent. Most bacterial isolates were resistant to other antibacterial agents used (amoxicillin, amoxicillin-clavulanate, gentamicin, co-trimoxazole, tetracycline, nalidixic acid, ciprofloxacin and ofloxacin). Overall prevalence of asymptomatic UTI was 24.94%. HIV patients on HAART had a one- to three-fold higher risk of acquiring UTI. CD4+ count was not associated with asymptomatic UTI.