Zofia Marchewka, Justyna Domagała, Brygida Knysz, Agnieszka Piwowar
Different risk factors for chronic kidney disease in HIV-infected patients
Better life expectancy due to successful antiretroviral therapy led to higher frequency of chronic kidney disease (CKD) in HIV positive patients. Pathogenicity of CKD in HIV infection is complex. In this paper factors influencing development of CKD in HIV positive patients receiving antiretroviral therapy were analysed. Based on the literature review direct effect of HIV on the development of HIVAN, thrombotic microangiopathy or HIV immune complex disease of the kidney (HIVICK) were discussed. Mechanisms of nephrotoxicity of the most often used antiretroviral drugs of combined antiretroviral therapy (cART) regimens, especially of a new prodrug containing tenofovir as well as compounds increasing drug`s bioavailability were presented. Also new nephrotoxic substances used during chemsex and co-morbidities influencing nephropathy in HIV positive individuals were analysed. Viral pathogens associated with kidney diseases such as CMV, EBV, VZV, adenoviruses and HBV or HCV were presented.
Multiplicity and diversity of presented factors indicate how important is the problem of CKD in HIV positive patients. Awareness and analysis of these factors, systematic monitoring of the kidney function allows to adapt and modify therapy carried by clinicians.
Keywords: HIV, chronic kidney disease, antiretroviral drugs, co-infection, chemsex
© Farm Pol, 2018, 74(3): 137-145