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Prevalence and Evolution of Renal Impairment in People Living With HIV in Rural Tanzania.


ABSTRACT: We assessed the prevalence, incidence, and predictors of renal impairment among people living with HIV (PLWHIV) in rural Tanzania.In a cohort of PLWHIV aged ?15 years enrolled from January 2013 to June 2016, we assessed the association between renal impairment (estimated glomerural filtration rate < 90 mL/min/1.73 m2) at enrollment and during follow-up with demographic and clinical characteristcis using logistic regression and Cox proportional hazards models.Of 1093 PLWHIV, 172 (15.7%) had renal impairment at enrollment. Of 921 patients with normal renal function at baseline, 117 (12.7%) developed renal impairment during a median follow-up (interquartile range) of 6.2 (0.4-14.7) months. The incidence of renal impairment was 110 cases per 1000 person-years (95% confidence interval [CI], 92-132). At enrollment, logistic regression identified older age (adjusted odds ratio [aOR], 1.79; 95% CI, 1.52-2.11), hypertension (aOR, 1.84; 95% CI, 1.08-3.15), CD4 count <200 cells/mm3 (aOR, 1.80; 95% CI, 1.23-2.65), and World Health Organization (WHO) stage III/IV (aOR, 3.00; 95% CI, 1.96-4.58) as risk factors for renal impairment. Cox regression model confirmed older age (adjusted hazard ratio [aHR], 1.85; 95% CI, 1.56-2.20) and CD4 count <200 cells/mm3 (aHR, 2.05; 95% CI, 1.36-3.09) to be associated with the development of renal impairment.Our study found a low prevalence of renal impairment among PLWHIV despite high usage of tenofovir and its association with age, hypertension, low CD4 count, and advanced WHO stage. These important and reassuring safety data stress the significance of noncommunicable disease surveillance in aging HIV populations in sub-Saharan Africa.

SUBMITTER: Mapesi H 

PROVIDER: S-EPMC5912087 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Prevalence and Evolution of Renal Impairment in People Living With HIV in Rural Tanzania.

Mapesi Herry H   Kalinjuma Aneth V AV   Ngerecha Alphonce A   Franzeck Fabian F   Hatz Christoph C   Tanner Marcel M   Mayr Michael M   Furrer Hansjakob H   Battegay Manuel M   Letang Emilio E   Weisser Maja M   Glass Tracy R TR  

Open forum infectious diseases 20180406 4


<h4>Background</h4>We assessed the prevalence, incidence, and predictors of renal impairment among people living with HIV (PLWHIV) in rural Tanzania.<h4>Methods</h4>In a cohort of PLWHIV aged ≥15 years enrolled from January 2013 to June 2016, we assessed the association between renal impairment (estimated glomerural filtration rate < 90 mL/min/1.73 m<sup>2</sup>) at enrollment and during follow-up with demographic and clinical characteristcis using logistic regression and Cox proportional hazard  ...[more]

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