Progressive Decline of the Glomerular Filtration Rate in HIV-infected Children Treated With Tenofovir Disoproxil Fumarate-based Regimens in West and Central Africa

Abstract

A cross-sectional study of 358 HIV-1-infected children and adolescents living in Sub-Saharan Africa treated with tenofovir disoproxil fumarate-based regimens for a median of 1.5 interquartile range [0.6–3.1 years] showed a loss of glomerular filtration rate estimated to be 0.41 mL/min/1.73 m2 per month of treatment. In contrast, there was no decrease depending on the duration of the previous antiretroviral treatment.

Prevalence of chronic kidney disease among young people living with HIV in Sub Saharan Africa: A systematic review and meta-analysis

“…Estimated GFR (eGFR) was used in 13 studies alone and in combination with markers of kidney damage (6, 33, 44–47, 51–53, 55–58). Five studies used an eGFR cut-off of <60ml/min/1.73m 2 (44–46, 55, 57), two used this cutoff alone without any marker of kidney damage (45, 57) and six used a cut-off of <90ml/min/1.73m 2 (6, 33, 47, 51, 53, 58). These studies showed a CKD prevalence between 0.8% and 35.9%.…”

“…Three studies recruited only YPLHIV who were perinatally infected (6, 33, 51). Among the studies that recruited ART-experienced participants, two included only those on TDF-containing regimens (45, 53). Four studies enrolled HIV-negative control groups from the general population (6, 33, 56, 57).…”

“…Only four studies repeated the tests to determine chronicity, at week 6 (49), month 3 (55), month 6 (51), and after an average of four years (47). Equations used to estimate GFR included modified Schwartz in six studies (6, 44, 45, 53, 55, 57), Modification of Diet in Renal Disease (MDRD) in two studies (46, 51), and the full-age spectrum formula in two studies (58, 47). The equation was not mentioned in the remaining three.…”

“…The proportion of female participants in each study was 40-58%. Three studies recruited participants who were ART-naïve (46,47,58), 11 studies recruited ART-experienced participants (6,33,44,45,48,(51)(52)(53)(55)(56)(57), and two studies recruited both ART-naïve and ART-experienced participants (49,50). Three studies recruited only YPLHIV who were perinatally infected (6,33,51).…”

“…The studies reported information on 4,365 participants from 32 ART clinics in 14 SSA countries. Four studies were from West Africa (44)(45)(46)(47), five from East Africa (48)(49)(50)(51)(52), six from Southern Africa (6,33,(53)(54)(55)(56) and one from Central Africa (57). Eligible studies were conducted between 2013 and 2023.…”