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Prevalence and Evolution of Renal Impairment in People Living With HIV in Rural Tanzania
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Background: We assessed the prevalence, incidence, and
predictors of renal impairment among people living with HIV
(PLWHIV) in rural Tanzania. Methods: 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(2)) at
enrollment and during follow-up with demographic and clinical
characteristcis using logistic regression and Cox proportional
hazards models. Results: 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/mm(3) (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/mm(3) (aHR, 2.05; 95% CI,
1.36-3.09) to be associated with the development of renal
impairment. Conclusions: 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.
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MAPESI, Herry, et al. Prevalence and Evolution of Renal Impairment in People Living
With HIV in Rural Tanzania. Open Forum Infectious Diseases. 2018. Vol. 5, num. 4. ISSN 2328-8957. [consulted: 14 of August of 2026]. Available at: https://hdl.handle.net/2445/122722