Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy?
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...
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The Journal of Infection in Developing Countries
2020-09-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/12030 |
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| author | Oscar Muñoz-Velandia Ángel García-Peña Javier Garzón-Herazo Kateir Contreras-Villamizar Martha Rodríguez-Sánchez Elias Garcia-Consuegra Esteban Toro-Trujillo |
| author_facet | Oscar Muñoz-Velandia Ángel García-Peña Javier Garzón-Herazo Kateir Contreras-Villamizar Martha Rodríguez-Sánchez Elias Garcia-Consuegra Esteban Toro-Trujillo |
| author_sort | Oscar Muñoz-Velandia |
| collection | DOAJ |
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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.
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| format | Article |
| id | doaj-art-6a8ebb0da1b14779b35c5ee07928af0f |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | The Journal of Infection in Developing Countries |
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| spelling | doaj-art-6a8ebb0da1b14779b35c5ee07928af0f2025-08-20T02:16:17ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802020-09-01140910.3855/jidc.12030Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy?Oscar Muñoz-Velandia0Ángel García-Peña1Javier Garzón-Herazo2Kateir Contreras-Villamizar3Martha Rodríguez-Sánchez4Elias Garcia-Consuegra5Esteban Toro-Trujillo6Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, ColombiaDepartment of Internal Medicine, Cardiology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, ColombiaDepartment of Internal Medicine, Infectology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, ColombiaDepartment of Internal Medicine, Nephrology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, ColombiaDepartment of Internal Medicine, Nephrology Unit, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, ColombiaDepartment of Internal Medicine, Pontificia Universidad Javeriana, Bogotá, ColombiaDepartment of Internal Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia 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. https://jidc.org/index.php/journal/article/view/12030HIVglomerular diseasesHIV-associated nephropathyhighly active antiretroviral therapy |
| spellingShingle | Oscar Muñoz-Velandia Ángel García-Peña Javier Garzón-Herazo Kateir Contreras-Villamizar Martha Rodríguez-Sánchez Elias Garcia-Consuegra Esteban Toro-Trujillo Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy? Journal of Infection in Developing Countries HIV glomerular diseases HIV-associated nephropathy highly active antiretroviral therapy |
| title | Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy? |
| title_full | Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy? |
| title_fullStr | Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy? |
| title_full_unstemmed | Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy? |
| title_short | Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy? |
| title_sort | glomerular diseases related to hiv in colombian population better outcomes with highly active antiretroviral therapy |
| topic | HIV glomerular diseases HIV-associated nephropathy highly active antiretroviral therapy |
| url | https://jidc.org/index.php/journal/article/view/12030 |
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