Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy?

  • Oscar Muñoz-Velandia Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
  • Ángel García-Peña Department of Internal Medicine, Cardiology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
  • Javier Garzón-Herazo Department of Internal Medicine, Infectology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
  • Kateir Contreras-Villamizar Department of Internal Medicine, Nephrology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
  • Martha Rodríguez-Sánchez Department of Internal Medicine, Nephrology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
  • Elias Garcia-Consuegra Department of Internal Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
  • Esteban Toro-Trujillo Department of Internal Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
Keywords: HIV, glomerular diseases, HIV-associated nephropathy, highly active antiretroviral therapy

Abstract

Introduction: End-stage renal disease (ESRD) related to HIV is becoming a leading cause of renal replacement therapy requirement is some areas of the world. Our study aims to describe the incidence and renal outcomes of HIV-associated nephropathy (HIVAN), and immune-mediated kidney disease related to HIV (HIVICK) in Colombia.

Methodology: A retrospective cohort study was performed, including all HIVAN or HIVICK incident cases assessed by the infectious diseases division in a high complexity institution in Colombia, between 2004 and 2018. A longitudinal data model under the Generalized Estimating Equations (GEE) method was used to determine changes on the glomerular filtration rate (GFR) over time.

Results: Within a cohort composed by 1509 HIV-infected patients, we identified 22 with HIV-associated glomerular disease. Cumulative incidence was 1.45%. At diagnosis, GFR was above 30 mL/min in 90.8% of patients, and 77.2% displayed sub-nephrotic proteinuria. Factors associated with GFR at diagnosis were: level of CD4 (Coefficient 0.113, CI 95 %: 0.046, 0.179, p < 0.01), and the inverse of the CD4/CD8 ratio. The GEE model did not demonstrate significant changes in the GFR over a 3-year period. Findings were similar when comparing GFR at diagnosis with GFR at 12 (-3.9 mL/min/1.73m2, CI 95% -7.3, 0.4, p = 0.98), 24 (-2.47 mL/min/1.73m2, CI 95% -7.0, 2.1, p=0.85), and 36 months (0.39 mL/min/1.73m2, CI 95% -4.4, 5.2, p = 0.43) of follow-up.

Conclusions: Patients with glomerular disease associated with HIV have stable GFR over a 3-year period, and low rates of progression towards dialysis requirement. Differences with previous reports could be related with early diagnosis and treatment with highly active antiretroviral therapy.

Published
2020-09-30
How to Cite
1.
Muñoz-Velandia O, García-Peña Ángel, Garzón-Herazo J, Contreras-Villamizar K, Rodríguez-Sánchez M, Garcia-Consuegra E, Toro-Trujillo E (2020) Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy?. J Infect Dev Ctries 14:1027-1032. doi: 10.3855/jidc.12030
Section
Original Articles