Journal of the International Association of Providers of AIDS Care (Apr 2022)

Impact of Antiretroviral Therapy on Kidney Disease in HIV Infected Individuals – A Qualitative Systematic Review

  • Harsha Adnani,
  • Nirav Agrawal,
  • Akshay Khatri,
  • Jaclyn Vialet,
  • Meng Zhang,
  • Joseph Cervia

DOI
https://doi.org/10.1177/23259582221089194
Journal volume & issue
Vol. 21

Abstract

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Kidney disease is the fourth most common cause of non-AIDS-related mortality in people living with HIV. Combination antiretroviral therapy (cART) remains the cornerstone of treatment. However, little is known about the impact of cART on disease outcomes in patients with HIV-associated nephropathy (HIVAN) and HIV-immune complex kidney disease (HIVICK). This systematic review evaluates the impact of cART on progression to end-stage kidney disease (ESKD) and other outcomes in HIV-infected individuals. We conducted a literature search utilizing PubMed, and Cochrane database and 11 articles met inclusion criteria for analysis of which nine HIVAN studies showed decreased progression to ESKD or death for subjects when treated with cART versus those untreated. However, two studies showed no survival advantage with cART. Three HIVICK studies showed improvement in delaying ESKD in subjects on cART compared to untreated subjects. cART appeared to reduce the risk to ESKD or death in patients with both HIVAN and HIVICK.