ArticleInternal medicine journal2026
Clinicopathological findings, correlations and outcomes in patients with renal disease and living with antiretroviral-treated human immunodeficiency virus infection.
Article in Internal medicine journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
BACKGROUND AND
aimsAntiretroviral therapy (ART) has modified the incidence of renal complications and the patterns of renal disease in people living with Human Immunodeficiency Virus (PLWH). We reviewed (2011-2021) the progress and outcomes (follow-up to mid-2025) of 158 such individuals.
methodsRenal biopsies (59 subjects (BxGp)) were appraised, categorised and semi-quantitated, and correlated with demographic, clinical and laboratory findings, and the progression of renal parameters was compared with 99 non-biopsied subjects (NBxGp). Longer-term outcomes (combined death and/or progression to end stage kidney disease (ESKD)) for both groups were assessed by regression.
resultsProteinuria was the commonest presentation, and levels were higher (P < 0.001) in BxGp subjects, especially those with glomerulonephritis, but did not correlate with semi-quantitated acute or chronic histology scores. Conversely, estimated glomerular filtration (eGFR) levels did correlate with both acute (r = -0.6397; P < 0.05) and chronic (r = -0.4451; P < 0.01) histology scores, but overall rates of eGFR deterioration were not different between BxGp and NBxGp. With cessation of tenofovir disoproxil fumarate (TDF), proteinuria specifically improved (P < 0.01), and eGFR stabilised in BxGp subjects with acute tubular injury. Proteinuria (but not eGFR) consistently predicted adverse longer-term outcomes in unadjusted and Lasso regression models.
conclusionsRenal biopsy is required for accurate diagnosis in ART-treated PLWH developing renal disease. Proteinuria is a high-priority prognostic marker in PLWH with renal disease but does not reliably predict underlying histopathology, and it was the only consistent risk factor predictor of longer-term adverse outcomes of ESKD and/or death.
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