PLoS ONE (Jan 2021)

Prevalence, incidence and predictors of renal impairment in persons with HIV receiving protease-inhibitors in rural Tanzania.

  • Herry Mapesi,
  • James Okuma,
  • Fabian Franzeck,
  • Herieth Ismael Wilson,
  • Elizabeth Senkoro,
  • Theonestina Byakuzana,
  • Robert Ndege,
  • Fiona Vanobberghen,
  • Tracy Renée Glass,
  • Manuel Battegay,
  • Maja Weisser,
  • Daniel Henry Paris,
  • KIULARCO Study Group

DOI
https://doi.org/10.1371/journal.pone.0261367
Journal volume & issue
Vol. 16, no. 12
p. e0261367

Abstract

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ObjectiveRitonavir-boosted protease inhibitors (bPI) in people living with HIV (PLWH) have been associated with renal impairment. Limited data are available from rural sub-Saharan Africa.MethodsUsing data from the Kilombero and Ulanga Antiretroviral Cohort Study (KIULARCO) in rural Tanzania from 2005-01/2020, we assessed the prevalence of renal impairment (estimated glomerular filtration rate ResultsRenal impairment was present in 52/687 PLWH (7.6%) at the switch to bPI. Among 556 participants with normal kidney function at switch, 41 (7.4%) developed renal impairment after a median time of 3.5 (IQR 1.6-5.1) years (incidence 22/1,000 person-years (95%CI 16.1-29.8)). Factors associated with renal impairment at switch were older age (adjusted odds ratio (aOR) 1.55 per 10 years; 95%CI 1.15-2.11), body mass index (BMI) ConclusionsIn PLWH in rural sub-Saharan Africa, prevalence and incidence of renal impairment among those who were switched from first-line to bPI-regimens were high. We found associations between renal impairment and older age, arterial hypertension, low BMI and time on ART.