Comparative Evaluation of Prevalence, Risk Factors, and Pathologic Features of Kidney Disease in Highly Active Antiretroviral Therapy-Naive and Highly Active Antiretroviral Therapy-Experienced Patients at a Tertiary Health Facility in Maiduguri, Northeastern Nigeria

Infection of the kidneys by human immunodeficiency virus (HIV) is known to cause kidney disease. HIV-associated nephropathy occurs with variable prevalence rates in various communities and is found to be higher among sub-Saharan Africans. The disease has not been studied in Northeastern Nigeria. This study was aimed at comparing the prevalence, clinical and histo-pathologic features of kidney disease among highly active antiretroviral therapy (HAART)-experienced and HAART-naive patients in northeastern Nigeria. Four hundred HIV infected (200 HAART-experienced and 200 HAART-naive) patients were recruited consecutively from the ART clinic. Their socio-demographic and laboratory data including CD4+ cell counts and viral loads were obtained and documented. Out of the 200 study participants in the HAARTexperienced arm, 21 (10.5%) had kidney disease whereas 61 (30.5%) participants in the HAARTnaive group had kidney disease. Their mean ages were 41.43 +/- 11.04 years and 37.42 +/- 9.96 years in the HAART-experienced and HAART-naive groups, respectively. The mean serum creatinine (SCr), CD4+ cell counts, and viral load were 185.67 +/- 221.80 mu mol/L, 493.26 +/- 241.97/mm3, and 8,856.79 +/- 19,747.11/mL in the HAART-experienced group, respectively. In the HAART-naive group, the mean SCr, CD4+ cell count, and viral load were 141.88 +/- 130.56 mu mol/L, 270.00 +/- 154.65 cells/mm3, and 139,217.70 +/- 12,598.50/mL. Focal segmental glomerulosclerosis (FSGS) was the most common histologic diagnosis in 64.7% of kidney biopsies.