Renal Function Among ART-Naive, HIV-Infected Patients
Renal Function Among ART-Naive, HIV-Infected Patients
Background: Renal insufficiency has been shown to be a significant, independent risk factor for mortality among HIV-infected patients. Unfortunately, little is known about the prevalence and nature of renal impairment in African populations initiating antiretroviral treatment. This study aims to find the prevalence of abnormal renal function among antiretroviral therapy (ART)-naive, HIV-infected patients in the South Eastern geopolitical zone of Nigeria.
Method: This is a cross-sectional hospital-based study, involving 300 ART-naive HIV-positive patients, seen over a 1-year period, aged from 18 years and older, presenting to the clinic for the first time.
Results: A total of 300 patients were included in the study, 104 (34.7%) males and 196 (65.3%) females. The prevalence of significant renal disease was 24.3% (73 of 300), while 38.3% (115 of 300) had mild renal impairment. Using logistic regression, age, CD4 count, urea, creatinine, and hemoglobin were significantly associated with renal impairment.
Conclusion: The authors observed a high prevalence of significant renal impairment among HIV-infected patients at the time of ART initiation.
Long-term infection with HIV is associated with numerous renal complications. It can cause HIV-associated nephropathy (HIVAN) or other disease states as a result of opportunistic infections, intercurrent illnesses, or other side effects related to treatment of HIV infection.
Studies from several sub-Saharan Africa have reported a variable prevalence of these diseases in HIV-infected patients: 6% in South Africa, 38% in Nigeria, 26% in Côte d'Ivoire, 28% in Tanzania, 25% in Kenya, 20%-48.5% in Uganda, and 33.5% in Zambia. Results from these studies also suggest that a broader spectrum of histopathological lesions in HIV-associated kidney disease exists in the African populations than was previously thought. Regardless of the underlying cause, however, renal insufficiency has been shown to be a significant, independent risk factor for mortality among HIV-infected patients.
Despite the high burden of both HIV and renal disease in sub-Saharan Africa and the rapid progression to end-stage renal disease (ESRD) in the absence of highly active antiretroviral therapy (HAART), few studies to date have tried to determine the true prevalence of abnormal renal function among antiretroviral therapy (ART)-naive patients. This study therefore aims to determine the prevalence of abnormal renal function among ART-naive, HIV-infected patients in the South Eastern geopolitical zone of Nigeria.
Abstract and Introduction
Abstract
Background: Renal insufficiency has been shown to be a significant, independent risk factor for mortality among HIV-infected patients. Unfortunately, little is known about the prevalence and nature of renal impairment in African populations initiating antiretroviral treatment. This study aims to find the prevalence of abnormal renal function among antiretroviral therapy (ART)-naive, HIV-infected patients in the South Eastern geopolitical zone of Nigeria.
Method: This is a cross-sectional hospital-based study, involving 300 ART-naive HIV-positive patients, seen over a 1-year period, aged from 18 years and older, presenting to the clinic for the first time.
Results: A total of 300 patients were included in the study, 104 (34.7%) males and 196 (65.3%) females. The prevalence of significant renal disease was 24.3% (73 of 300), while 38.3% (115 of 300) had mild renal impairment. Using logistic regression, age, CD4 count, urea, creatinine, and hemoglobin were significantly associated with renal impairment.
Conclusion: The authors observed a high prevalence of significant renal impairment among HIV-infected patients at the time of ART initiation.
Introduction
Long-term infection with HIV is associated with numerous renal complications. It can cause HIV-associated nephropathy (HIVAN) or other disease states as a result of opportunistic infections, intercurrent illnesses, or other side effects related to treatment of HIV infection.
Studies from several sub-Saharan Africa have reported a variable prevalence of these diseases in HIV-infected patients: 6% in South Africa, 38% in Nigeria, 26% in Côte d'Ivoire, 28% in Tanzania, 25% in Kenya, 20%-48.5% in Uganda, and 33.5% in Zambia. Results from these studies also suggest that a broader spectrum of histopathological lesions in HIV-associated kidney disease exists in the African populations than was previously thought. Regardless of the underlying cause, however, renal insufficiency has been shown to be a significant, independent risk factor for mortality among HIV-infected patients.
Despite the high burden of both HIV and renal disease in sub-Saharan Africa and the rapid progression to end-stage renal disease (ESRD) in the absence of highly active antiretroviral therapy (HAART), few studies to date have tried to determine the true prevalence of abnormal renal function among antiretroviral therapy (ART)-naive patients. This study therefore aims to determine the prevalence of abnormal renal function among ART-naive, HIV-infected patients in the South Eastern geopolitical zone of Nigeria.