Kidney function impairment among adult people living with HIV on antiretroviral therapy in South-West, Nigeria

Abstract

Human immunodeficiency virus (HIV) infection and use of antiretroviral therapy (ART) pose a significant risk of causing kidney function impairment in people living with HIV (PLHIV) and could contribute to their morbidity and mortality. Clinicians and healthcare providers ought to encourage routine screening for kidney function to optimize therapy in this disease population. The aim of this study is to assess the prevalence and predictors of kidney function impairment among HIV patients on ART. We conducted a retrospective cohort analysis on electronic data collected among HIV patients ≥ 18 years who received ART between 2006 and 2023. Patients’ demographic data, clinical data and ART received were retrieved. Each patient’s estimated glomerular filtration rate (eGFR) assessed accordingly. Descriptive statistics and logistic regression analysis were done using SPSS 29.02 software. Out of 1026 HIV patients on ART data analyzed in this study, 66.9% were females and the prevalence of kidney function impairment (eGFR < 60 mL/min/1.73 m2) was 42.5%. Factors associated with kidney function impairment identified were tenofovir disoproxil fumarate (TDF) based regimen [aOR = 225.3 (CI: 89.5–567.2), p < 0.001], female gender [aOR = 6.67, (CI: 4.48–9.92), p < 0.001], WHO clinical stage [aOR = 2.64 (CI: 1.47–4.73), p < 0.001], and CD4 count [aOR = 2.51 (CI: 1.56–4.05), p < 0.001]. There is a high prevalence of kidney function impairment among PLHIV on ART and could be associated with female gender, CD4 cell count, WHO clinical stage and the use of TDF-based regimen. We recommend early screening for kidney function before commencing ART and monitoring for timely intervention to reduce the risk for further damage to the kidneys.