Predictors of renal outcome in HIV-associated nephropathy - PubMed (original) (raw)
. 2008 Apr 15;46(8):1282-9.
doi: 10.1086/529385.
Lucy J Campbell, Lisa Hamzah, Lisa Collins, Rachael Jones, Rizwan Siwani, Leann Johnson, Martin Fisher, Stephen G Holt, Sanjay Bhagani, Andrew H Frankel, Edmund Wilkins, Jonathan G Ainsworth, Nick Larbalestier, Derek C Macallan, Debasish Banerjee, Guy Baily, Raj C Thuraisingham, Paul Donohoe, Bruce M Hendry, Rachel M Hilton, Simon G Edwards, Robert Hangartner, Alexander J Howie, John O Connolly, Philippa J Easterbrook
Affiliations
- PMID: 18444868
- DOI: 10.1086/529385
Predictors of renal outcome in HIV-associated nephropathy
Frank A Post et al. Clin Infect Dis. 2008.
Abstract
Background: Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) is an important cause of end-stage renal disease among African American patients. This study was performed to study the epidemiology of HIVAN in a predominantly black African population and the impact of highly active antiretroviral therapy and other factors on the development of end-stage renal disease.
Methods: We retrospectively identified all patients with HIVAN, defined by biopsy or strict clinical criteria, in 8 clinics in the United Kingdom. Baseline renal function, HIV parameters, renal pathological index of chronic damage, and responses to highly active antiretroviral therapy were analyzed, and factors associated with adverse renal outcome were identified.
Results: From 1998 through 2004, we studied 16,834 patients, 61 of whom had HIVAN. HIVAN prevalence in black patients was 0.93%, and HIVAN incidence in those without renal disease at baseline was 0.61 per 1000 person-years. After a median of 4.2 years, 34 patients (56%) had developed end-stage renal disease. There were no significant differences in renal function and HIV parameters at baseline, time to initiation of highly active antiretroviral therapy, and rates of HIV RNA suppression between the 20 patients who developed end-stage renal disease >3 months after receiving the HIVAN diagnosis and the 23 patients who maintained stable renal function. However, the index of chronic damage score was significantly higher in those who developed end-stage renal disease (P < .001), and an index of chronic damage score >75 was associated with shorter renal survival (P < .001).
Conclusions: Whereas overall patient survival suggested an important benefit of highly active antiretroviral therapy, no additional renal benefit of early initiation of highly active antiretroviral therapy or viral suppression could be demonstrated in this large cohort of patients with established HIVAN. Severity of chronic kidney damage, as quantified by biopsy, was the strongest predictor of renal outcome.
Similar articles
- Presentation of HIV-associated nephropathy and outcome in HAART-treated patients.
Bigé N, Lanternier F, Viard JP, Kamgang P, Daugas E, Elie C, Jidar K, Walker-Combrouze F, Peraldi MN, Isnard-Bagnis C, Servais A, Lortholary O, Noël LH, Bollée G. Bigé N, et al. Nephrol Dial Transplant. 2012 Mar;27(3):1114-21. doi: 10.1093/ndt/gfr376. Epub 2011 Jul 10. Nephrol Dial Transplant. 2012. PMID: 21745806 - Effect of highly active antiretroviral therapy on renal failure in human immunodeficiency virus-associated nephropathy.
Takahashi T, Nakamura T, Kanda T, Iwamoto A. Takahashi T, et al. Res Commun Mol Pathol Pharmacol. 2004;115-116:151-6. Res Commun Mol Pathol Pharmacol. 2004. PMID: 17564314 - HIV-associated nephropathy: case study and review of the literature.
Ross MJ, Klotman PE, Winston JA. Ross MJ, et al. AIDS Patient Care STDS. 2000 Dec;14(12):637-45. doi: 10.1089/10872910050206559. AIDS Patient Care STDS. 2000. PMID: 11119430 Review. - HIV-associated nephropathy is a late, not early, manifestation of HIV-1 infection.
Winston JA, Klotman ME, Klotman PE. Winston JA, et al. Kidney Int. 1999 Mar;55(3):1036-40. doi: 10.1046/j.1523-1755.1999.0550031036.x. Kidney Int. 1999. PMID: 10027941 Review.
Cited by
- An Update on Viral Infection-Associated Collapsing Glomerulopathy.
Fisher M, Ross M, DiFranza L, Reidy K. Fisher M, et al. Adv Kidney Dis Health. 2024 Jul;31(4):317-325. doi: 10.1053/j.akdh.2023.12.007. Adv Kidney Dis Health. 2024. PMID: 39084757 Review. - The Role of Sodium-Glucose Cotransporter-2 Inhibitors in the Treatment Paradigm of CKD in Africa: An African Association of Nephrology Panel Position Paper.
Jarraya F, Niang A, Bagha H, Tannor EK, Sumaili EK, Wan DIM, Chothia MY, Mengistu YT, Kaze FF, Ulasi II, Naicker S, Hafez MH, Yao KH. Jarraya F, et al. Kidney Int Rep. 2023 Dec 24;9(3):526-548. doi: 10.1016/j.ekir.2023.12.019. eCollection 2024 Mar. Kidney Int Rep. 2023. PMID: 38481515 Free PMC article. No abstract available. - HIV-Associated Nephropathy in 2022.
Rivera FB, Ansay MFM, Golbin JM, Alfonso PGI, Mangubat GFE, Menghrajani RHS, Placino S, Taliño MKV, De Luna DV, Cabrera N, Trinidad CN, Kazory A. Rivera FB, et al. Glomerular Dis. 2022 Oct 24;3(1):1-11. doi: 10.1159/000526868. eCollection 2023 Jan-Dec. Glomerular Dis. 2022. PMID: 36816427 Free PMC article. Review. - Genetic Variants of APOL1 Are Major Determinants of Kidney Failure in People of African Ancestry With HIV.
Hung RKY, Binns-Roemer E, Booth JW, Hilton R, Harber M, Santana-Suarez B, Campbell L, Fox J, Ustianowski A, Cosgrove C, Burns JE, Clarke A, Price DA, Chadwick D, Onyango D, Hamzah L, Bramham K, Sabin CA, Winkler CA, Post FA; GEN-AFRICA Study Group. Hung RKY, et al. Kidney Int Rep. 2022 Jan 25;7(4):786-796. doi: 10.1016/j.ekir.2022.01.1054. eCollection 2022 Apr. Kidney Int Rep. 2022. PMID: 35497797 Free PMC article. - Impact of Antiretroviral Therapy on Kidney Disease in HIV Infected Individuals - A Qualitative Systematic Review.
Adnani H, Agrawal N, Khatri A, Vialet J, Zhang M, Cervia J. Adnani H, et al. J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582221089194. doi: 10.1177/23259582221089194. J Int Assoc Provid AIDS Care. 2022. PMID: 35369795 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources