Renal outcomes in adults with HBV, HIV and HBV/HIV coinfection after 3 years of antiviral therapy in urban Tanzania

En Ling Wu*, Beatrice Christian, Adovich S. Rivera, Emanuel Fabian, Irene Macha, Eric Aris, Shida Mpangala, Nzovu Ulenga, Ferdinand Mugusi, Robert L. Murphy, Claudia A. Hawkins

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: An enhanced understanding of renal outcomes in persons with chronic HBV, HIV, and HBV/HIV coinfection is needed to mitigate chronic kidney disease in regions where HBV and HIV are endemic. Objectives: To investigate changes in estimated glomerular filtration rate (eGFR) in adults with HBV, HIV or HBV/ HIV enrolled in a 3 year prospective cohort study of liver outcomes in Dar es Salaam, Tanzania and initiated on antiviral therapy. Methods: We compared eGFR between and within groups over time using mixed-effects models. Results: Four hundred and ninety-nine participants were included in the analysis (HBV: 164; HIV: 271; HBV/HIV: 64). Mean baseline eGFRs were 106.88, 106.03 and 107.18 mL/min/1.73 m2, respectively. From baseline to Year 3, mean eGFR declined by 4.3 mL/min/1.73 m2 (95% CI -9.3 to 0.7) and 3.7 (-7.8 to 0.5) in participants with HBV and HIV, respectively, and increased by 5.1 (-4.7 to 14.9) in those with HBV/HIV. In multivariable models, participants with HBV had lower eGFRs compared with those with HIV or HBV/HIV and, after adjusting for HBV DNA level and hepatitis B e antigen (HBeAg) status, significantly lower eGFRs than those with HBV/HIV at all follow-up visits. Conclusions: In this Tanzanian cohort, coinfection with HBV/HIV did not appear to exacerbate renal dysfunction compared with those with either infection alone. Although overall changes in eGFR were small, persons with HBV experienced lower eGFRs throughout follow-up despite their younger age and similar baseline values. Longer-term studies are needed to evaluate continuing changes in eGFR and contributions from infection duration and other comorbidities.

Original languageEnglish (US)
Pages (from-to)36-45
Number of pages10
JournalJournal of antimicrobial chemotherapy
Volume79
Issue number1
DOIs
StatePublished - Jan 1 2024

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases
  • Pharmacology

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