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 language | English (US) |
|---|---|
| Pages (from-to) | 36-45 |
| Number of pages | 10 |
| Journal | Journal of antimicrobial chemotherapy |
| Volume | 79 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2024 |
Funding
The analysis was conducted using longitudinal data collected from adults with HIV, HBV or HBV/HIV enrolled in a prospective cohort study of liver outcomes between September 2013 and December 2015 following written informed consent, which was subject to ethical reviews by the National Institute for Medical Research, Dar es Salaam, Tanzania, and Northwestern University. Study participants were recruited from eight HIV Care and Treatment Clinics (CTCs) and an HBV clinic in Dar es Salaam. Study sites were supported by the Management and Development for Health (MDH) under the President's Emergency Plan for AIDS Relief. Inclusion criteria were: (i) adults at least 18 years of age; (ii) known HIV and HBV status; and (iii) antiretroviral (HIV, HBV/HIV) or antiviral (HBV) treatment naive. Chronic HBV was defined as hepatitis B surface antigen seropositivity on at least one occasion within the past 6 months. Participants were excluded if they were pregnant or had active TB, positive anti-hepatitis C antibody, known history of hepatocellular carcinoma, or clinical evidence of advanced liver disease (jaundice, hepatic encephalopathy, ascites, abnormal bleeding). , The work was supported by grant K23 DK095707 from the National Institute of National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the Robert J. Havey, MD Institute for Global Health at Northwestern University, and the Richard and Susan Kiphart Northwestern Global Health Research Fund. The contents are solely the responsibility of the authors and do not represent the official views of the funding institutions.
ASJC Scopus subject areas
- Pharmacology
- Microbiology (medical)
- Pharmacology (medical)
- Infectious Diseases
