APOL1 Renal Risk Variants and Kidney Function in HIV-1–Infected People From Sub-Saharan Africa

Abstract

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Apolipoprotein L1 Genetic Variants in Cameroonians with chronic kidney disease: A case control study

“…Kabore et al recently reported that the prevalence of the APOL1 genetic variants were lower in Senegal and Burkina Faso than previously reported in other west African countries with a prevalence of 13.3% amongst people living with HIV [8,11]. Furthermore, they did not nd an increased risk for declining kidney function in the CKD participants with the high risk APOL1 genetic variants [11]. This could be because of their limited sample size as the number of high risk carriers amongst the CKD population were few.…”

“…It has also been observed that the APOL1 risk variants; could predict the baseline histopathology and progression to ESRD in HIV-related kidney disease, was associated with prevalent kidney disease and also with lower age of dialysis initiation in African and Hispanic Americans [3,6,7]. A few studies in sub Saharan Africa have shown a high frequency of APOL1 risk variants in the CKD population [8][9][10][11]. The true prevalence of CKD in Cameroon is not known and the risk factors have not been extensively studied [12].…”

“…Data on genetic susceptibility especially APOL 1 mutations in CKD is lacking. However, in the Cameroonian population, the allelic frequencies of APOL G1 and G2 were reported at 8.7% and 8.9% respectively and that the prevalence of the high risk APOL1 variant was 3.4% in HIV infected patients in the Cameroon [11]. We therefore sought to nd out if the APOL1 genetic variants are a risk factor for non-diabetic CKD in the Cameroonian population.…”

Host factors predisposing to kidney disease in people with HIV

“…Kidney-risk genotypes are particularly common among West-Africans and people of West-African ancestry including African Americans and Caribbeans and are present in approximately 80% of people with HIVAN [36 ▪▪ ]. In Black people with HIV, kidney-risk genotypes have been associated with eGFR <60 ml/min/1.73 m 2 , ESKD, albuminuria/proteinuria, and eGFR decline during follow up [40–42,43 ▪ ,44 ▪ ,45 ▪▪ ]. An estimated 49% of ESKD in this population may be attributable to APOL1 kidney-risk genotypes [45 ▪▪ ].…”

“…Most studies support a recessive model for APOL1 nephropathy, indicating that two APOL1 risk alleles are required to cause kidney disease [43 ▪ ,44 ▪ ,45 ▪▪ ]. However, some studies have suggested a single risk allele may also predispose, albeit to a lesser extent, to CKD [34,35,46], particularly in the setting of HIV viraemia, which upregulates APOL1 production in podocytes [47].…”