Chronic Kidney Disease (CKD) in Patients Living with HIV under Antiretroviral Treatment: Prevalence and Risk Factors

Abstract

CKD is one of the major complications when infected by HIV. The surveillance of CKD indicators and control of its determinants in the HIV-infected population in our African communities is essential. This was a descriptive and analytical cross-sectional study of people living with HIV received at the Ambulatory Treatment Center (ATC) at Infectious Diseases department of Sylvanus Olympio University Hospital (CHU-SO). The study period was 6 months—from January 1, 2018 to June 30, 2018—CKD was defined by a clearance below 60 ml/min/1.73 m2 for at least 3 months. A total of 117 patients were enrolled during the study period. The average age of patients for trial treatment was between 9.49 and 42.0 7 years. The duration of follow-up for antiretroviral treatment was ±3.22 to ±5.64 years. The female gender was predominant (70.09%) with a sex ratio (M/F) of 0.43. Most of people living with HIV were mostly classified at clinical stage 2 (31.03%) and 3 (31.90%) of WHO at initiation of HAART. The main CD4 rate was 223.30 ± 143.764 at initiation of HAART and 462.58 ± 202.723 at the time of the study. The majority of patients were placed in a fixed combination of Tenofovir/Lamivudine/Efavirenz in a proportion of 81.20% cases. CKD was found in 13 patients—that is 11.11% of patients. Univariate analysis shows that age greater than 45 years plus (p = 0.017) and pathological proteinuria (p = 0.021) were associated with CKD. In multivariate analysis, only ages (p = 0.045) and pathological proteinuria (p = 0.035) were significantly associated with CKD. The prevalence of CKD in HIV-infected patients is significant in Togo. The occurrence of proteinuria is linked to the delay in taking antiretroviral therapy.