Hanser Sidney, Choshi Joel, Mokoena Haskly, Mabhida Sihle E, Mchiza Zandile J R, Moetlediwa Marakiya T, Muvhulawa Ndivhuwo, Nkambule Bongani B, Ndwandwe Duduzile, Nqebelele Unati, Kengne André P, Dludla Phiwayinkosi V
Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa.
Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
Front Med (Lausanne). 2024 Mar 19;11:1295217. doi: 10.3389/fmed.2024.1295217. eCollection 2024.
The introduction of antiretroviral therapy (ART) has significantly prolonged the lifespan of people living with human immunodeficiency virus (PLWH). However, the sustained use of this drug regimen has also been associated with a cluster of metabolic anomalies, including renal toxicity, which can lead to the development of kidney diseases. In this study, we reviewed studies examining kidney disease in PLWH sourced from electronic databases such as PubMed/MEDLINE, Scopus, and Google Scholar, as well as gray literature. The narrative synthesis of data from these clinical studies demonstrated that the serum levels of cystatin C remained unchanged or were not affected in PLWH on ART, while the creatinine-based glomerular filtration rate (GFR) fluctuated. In fact, some of the included studies showed that the creatinine-based GFR was increased in PLWH taking tenofovir disoproxil fumarate-containing ART, perhaps indicating that the use of both cystatin C- and creatinine-based GFRs is vital to monitor the development of kidney disease in PLWH. Clinical data summarized within this study indicate the potential detrimental effects of tenofovir-based ART regimens in causing renal tubular injury, while highlighting the possible beneficial effects of dolutegravir-based ART on improving the kidney function in PLWH. However, the summarized literature remains limited, while further clinical studies are required to provide insights into the potential use of cystatin C as a biomarker for kidney disease in PLWH.
抗逆转录病毒疗法（ART）的引入显著延长了人类免疫缺陷病毒感染者（PLWH）的寿命。然而，持续使用这种药物疗法也与一系列代谢异常有关，包括肾毒性，这可能导致肾脏疾病的发展。在本研究中，我们回顾了从电子数据库（如PubMed/MEDLINE、Scopus和谷歌学术搜索）以及灰色文献中获取的关于PLWH肾脏疾病的研究。对这些临床研究数据的叙述性综合分析表明，接受ART治疗的PLWH中，胱抑素C的血清水平保持不变或未受影响，而基于肌酐的肾小球滤过率（GFR）则有所波动。事实上，一些纳入研究表明，服用含富马酸替诺福韦二吡呋酯的ART的PLWH中，基于肌酐的GFR升高，这可能表明同时使用基于胱抑素C和肌酐的GFR对于监测PLWH肾脏疾病的发展至关重要。本研究总结的临床数据表明，基于替诺福韦的ART方案可能对肾小管造成损伤，同时强调了基于多替拉韦的ART对改善PLWH肾功能可能具有的有益作用。然而，总结的文献仍然有限，还需要进一步的临床研究来深入了解胱抑素C作为PLWH肾脏疾病生物标志物的潜在用途。
