Predictive factors and prevalence of microalbuminuria in HIV-infected patients: a cross-sectional analysis

Falasca, Katia; Nicola, Marta Di; Porfilio, Italo; Ucciferri, Claudio; Schiaroli, Elisabetta; Gabrielli, Chiara; Francisci, Daniela; Vecchiet, Jacopo

doi:10.1186/s12882-017-0672-9

Cited by 11 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding suggested that albuminuria, which was associated with HIV, may be improved by ART as previously reported [59]. This finding agrees with a few studies which have shown the proportion of albuminuria to be high in persons with HIV [60,61].…”

Section: Discussionsupporting

confidence: 91%

Relationship between Endothelial Function, Antiretroviral Treatment and Cardiovascular Risk Factors in HIV Patients of African Descent in South Africa: A Cross-Sectional Study

Nkeh-Chungag

Goswami

Engwa

et al. 2021

JCM

View full text Add to dashboard Cite

Limited information on the effect of antiretroviral treatment (ART) on vascular function in South Africans of African descent living with human immunodeficiency virus (HIV) is available. The relationship between ART, vascular function and cardiovascular risk factors in South Africans of African ancestry with HIV was therefore studied. This cross-sectional study recruited 146 HIV-positive individuals on ART (HIV+ART+), 163 HIV-positive individuals not on ART (HIV+ART−) and 171 individuals without HIV (HIV−) in Mthatha, Eastern Cape Province of South Africa. Flow-mediated dilation (FMD) test was performed to assess endothelial function. Anthropometry and blood pressure parameters were measured. Lipid profile, glycaemic indices, serum creatinine as well as CD4 count and viral load were assayed in blood. Urinary albumin to creatinine ratio (ACR) was determined as a marker of cardiovascular risk. Obesity and albuminuria were positively associated with HIV, and HIV+ART+ participants had significantly higher HDL cholesterol. Dyslipidaemia markers were significantly higher in hypertensive HIV+ART+ participants compared with the controls (HIV+ART− and HIV− participants). FMD was not different between HIV+ART+ participants and the controls. Moreover, HIV+ART+ participants with higher FMD showed lower total cholesterol and LDL cholesterol comparable to that of HIV− and HIV+ART− participants. A positive relationship between FMD and CD4 count was observed in HIV+ART+ participants. In conclusion, antiretroviral treatment was associated with cardiovascular risk factors, particularly dyslipidaemia, in hypertensive South Africans of African ancestry with HIV. Although, ART was not associated with endothelial dysfunction, flow-mediated dilatation was positively associated with CD4 count in HIV-positive participants on ART.

show abstract

Section: Discussionsupporting

confidence: 91%

Relationship between Endothelial Function, Antiretroviral Treatment and Cardiovascular Risk Factors in HIV Patients of African Descent in South Africa: A Cross-Sectional Study

Nkeh-Chungag

Goswami

Engwa

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Variable associations between fracture risk and low CD4 cell count (45,25) and HCV infection have been reported in previous studies (25,48). TDF use has been associated with higher risk of proteinuria (20,43,47) and fractures in several studies (49), while others failed to demonstrate such associations (45,25). Since the median TDF exposure at the index visit was only of 1 year we further examined the distribution of cumulative TDF use at visits after the index visit.…”

Section: Discussionmentioning

confidence: 85%

“…Consistent with data from prior studies (41), the prevalence of proteinuria observed in our cohort was higher in men with HIV compared to men without HIV (29% versus 6%). See comment in PubMed Commons below HIV-related kidney disease is multifactorial, resulting from direct HIV infection and damage of the renal epithelial cells (41-42), ARTrelated renal tubular toxicity (43)(44)(45), comorbidities such as HCV (46), diabetes mellitus or HTN, as well as low CD4 (47). In the multivariable analysis restricted to HIV+ men, proteinuria was associated with higher risk of fragility fracture independent of other HIVspecific and non-specific risk factors such as HTN and eGFR.…”

Section: Discussionmentioning

confidence: 99%

Proteinuria Is Associated With Increased Risk of Fragility Fracture in Men With or at Risk of HIV Infection

Gonciulea

Wang

Althoff

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background: Proteinuria has been associated with bone loss and fractures in general population but data in HIV-infected population is lacking. Setting: Prospective, multicenter cohort study of men with or at risk for HIV infection. Methods: Between 2006 and 2015, urine protein measurements and bone fracture histories were ascertained semi-annually in 947 HIV-infected (HIV+) and 969 HIV-uninfected (HIV-) men ≥ age 40. Proteinuria was defined as protein-to-creatinine ratio ≥ 200 mg/g at ≥ 2 consecutive visits. Outcome measures: 1) all fractures (excluding fractures of skull, face, digits) 2) fragility fractures (fractures of vertebral column, femur, wrist, humerus). Multivariable Cox proportional hazards models assessed the association between proteinuria and fracture after adjusting for additional risk factors. Results: The overall period prevalence of proteinuria was higher among HIV+ than HIV-(29% vs 6%, p<0.001). Men with proteinuria had a significantly higher risk of fragility fracture compared to men without proteinuria (aHR=2.29 [1.12-4.66]), and did not differ by HIVserostatus (p-interaction=0.83). The risk of all fractures was not statistically different between men with or without proteinuria (aHR=1.31 [0.84-2.05]). Among HIV+ men, the association between confirmed proteinuria and fragility fracture was attenuated (aHR=2.12 [0.95-4.73]) after additional adjustment for CD4 + T cell count/mm 3 , history of AIDS, the presence of detectable plasma HIV-1 RNA, and cumulative exposure to tenofovir disoproxil fumarate.

show abstract

“…Also, a detectable viral load is associated with a higher risk of MI [45]. However, biomarkers of inflammation and immune activation such as CRP, microalbuminuria, cystatin C and soluble CD14 are elevated in HIV-infected patients even when on cART [31,[46][47][48], reflecting residual inflammatory/immune activation. Consistent with these findings, we did not find any correlation between the evaluated parameters and viral load or CD4 count, suggesting that, after viral suppression, the detrimental factors leading to atherothrombotic events are not completely normalized, and may reflect the excess CV risk observed in HIV-infected patients even when successfully treated with ART [6,7,49,50].…”

Section: Discussionmentioning

confidence: 99%

“…Key demographic data (age, gender and nationality), clinical data [body mass index (BMI), year of HIV infection, presence of coinfection with hepatitis B or C virus (HBV/ HCV) and Centers for Disease Control and Prevention (CDC) category], viroimmunological data [CD4 count and HIV RNA, measured using polymerase chain reaction (PCR)], and therapeutic and laboratory data (hepatic and renal function, glucose concentration and lipid profile) were assessed in all subjects. Microalbuminuria was measured on single-day urine samples using particle-enhanced immunonephelometric assays (BN II System; Siemens Healthcare Diagnostics, Inc., NY, USA) [31]. The groups were homogeneous for gender and CDC classification.…”

Section: Study Populationmentioning

confidence: 99%

Circulating CD40 ligand, Dickkopf‐1 and P‐selectin in HIV‐infected patients

et al. 2019

Self Cite

View full text Add to dashboard Cite

Objectives The aim of this study was to evaluate the circulating levels of CD40 ligand (CD40 L), Dickkopf‐1 (DKK‐1) and P‐selectin, their relationships and their contributions to cardiovascular risk in subjects with HIV infection. Methods The study population included 80 HIV‐infected patients, 14 (17.5%) of whom had diabetes mellitus (DM) and 32 (40.0%) of whom had arterial hypertension (AH). The HIV‐infected patients were compared with a control group with similar demographic and clinical features. CD40L, DKK‐1 and P‐selectin levels were measured using an enzyme‐linked immunosorbent assay. Results The HIV‐infected patients showed higher levels of all the cardiovascular disease (CVD) markers. Both serum CD40L and DKK‐1 were significantly higher in HIV‐infected patients than in the HIV‐negative controls (P < 0.001), while soluble P‐selectin showed no significant between‐group difference (P = 0.133), reflecting the role of HIV infection in CVD. In the HIV‐infected group, patients with DM showed lower levels of CD40L and DKK‐1 in comparison with the nondiabetic patients and patients with AH (P < 0.05, with Bonferroni correction). In contrast, patients with AH showed higher levels of CD40L and DKK‐1 in comparison to patients without DM or AH (P < 0.05, with Bonferroni correction). Patients with AH showed higher levels of CD40L and DKK‐1 than patients with DM (P < 0.05, with Bonferroni correction). Conclusions In this study, we found that HIV‐infected patients displayed significantly higher circulating levels of both CD40L and DKK‐1, which were linearly and directly correlated, when compared to HIV‐negative patients. The presence of diabetes was associated with lower levels of both CD40L and DKK‐1, whereas the presence of hypertension was associated with higher levels of CD40L.

show abstract

Predictive factors and prevalence of microalbuminuria in HIV-infected patients: a cross-sectional analysis

Cited by 11 publications

References 38 publications

Relationship between Endothelial Function, Antiretroviral Treatment and Cardiovascular Risk Factors in HIV Patients of African Descent in South Africa: A Cross-Sectional Study

Relationship between Endothelial Function, Antiretroviral Treatment and Cardiovascular Risk Factors in HIV Patients of African Descent in South Africa: A Cross-Sectional Study

Proteinuria Is Associated With Increased Risk of Fragility Fracture in Men With or at Risk of HIV Infection

Circulating CD40 ligand, Dickkopf‐1 and P‐selectin in HIV‐infected patients

Contact Info

Product

Resources

About