TY - JOUR AU - Muñoz-Velandia, Oscar AU - García-Peña, Ángel AU - Garzón-Herazo, Javier AU - Contreras-Villamizar, Kateir AU - Rodríguez-Sánchez, Martha AU - Garcia-Consuegra, Elias AU - Toro-Trujillo, Esteban PY - 2020/09/30 Y2 - 2024/03/29 TI - Glomerular diseases related to HIV in Colombian population: Better outcomes with highly active antiretroviral therapy? JF - The Journal of Infection in Developing Countries JA - J Infect Dev Ctries VL - 14 IS - 09 SE - Original Articles DO - 10.3855/jidc.12030 UR - https://www.jidc.org/index.php/journal/article/view/33031092 SP - 1027-1032 AB - <p>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.</p><p>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.</p><p>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, <em>p</em> &lt; 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/1.73m<sup>2</sup>, CI 95% -7.3, 0.4, <em>p</em> = 0.98), 24 (-2.47 mL/min/1.73m<sup>2</sup>, CI 95% -7.0, 2.1, <em>p</em>=0.85), and 36 months (0.39 mL/min/1.73m<sup>2</sup>, CI 95% -4.4, 5.2, <em>p </em>= 0.43) of follow-up.</p><p>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.</p> ER -