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. 2021 Jul;100(1):146-154.
doi: 10.1016/j.kint.2021.03.038. Epub 2021 Apr 24.

Apolipoprotein-1 risk variants and associated kidney phenotypes in an adult HIV cohort in Nigeria

Usman J Wudil  1 , Muktar H Aliyu  2 , Heather L Prigmore  3 , Donna J Ingles  1 , Aima A Ahonkhai  4 , Baba M Musa  5 , Hamza Muhammad  6 , Mahmoud U Sani  6 , Aisha M Nalado  6 , Aliyu Abdu  6 , Kabiru Abdussalam  7 , Bryan E Shepherd  3 , Faisal S Dankishiya  6 , Anna M Burgner  8 , T Alp Ikizler  8 , Christina M Wyatt  9 , Jeffrey B Kopp  10 , Paul L Kimmel  10 , Cheryl A Winkler  11 , C William Wester  12
Affiliations

Apolipoprotein-1 risk variants and associated kidney phenotypes in an adult HIV cohort in Nigeria

Usman J Wudil et al. Kidney Int. 2021 Jul.

Abstract

HIV-positive adults are at risk for various kidney diseases, and apolipoprotein 1 (APOL1) high-risk genotypes increase this risk. This study aimed to determine the prevalence and ethnic distribution of APOL1 risk genotypes among a cohort of HIV-positive Nigerian adults and explore the relationship between APOL1 risk variant status with albuminuria and estimated glomerular filtration rate (eGFR). We conducted a cross-sectional study among 2 458 persons living with HIV who attended an HIV clinic in northern Nigeria and had received antiretroviral therapy for a minimum of six months. We collected two urine samples four-eight weeks apart to measure albumin excretion, and blood samples to measure eGFR and determine APOL1 genotype. The frequency of APOL1 high-risk genotype was 6.2%, which varied by ethnic group: Hausa/Fulani (2.1%), Igbo (49.1%), and Yoruba (14.5%). The prevalence of microalbuminuria (urine/albumin creatinine ratio 30- 300 mg/g) was 37%, and prevalence of macroalbuminuria (urine/albumin creatinine ratio over 300 mg/g) was 3%. The odds of microalbuminuria and macroalbuminuria were higher for participants with the APOL1 high-risk genotype compared to those carrying the low-risk genotype ([adjusted odds ratio 1.97, 95% confidence interval 1.37-2.82] and [3.96, 1.95-8.02] respectively). APOL1 high-risk genotype participants were at higher risk of having both an eGFR under 60 ml/min/1.73m2 and urine/albumin creatinine ratio over 300 mg/g (5.56, 1.57-19.69). Thus, we found a high proportion of HIV-positive, antiretroviral therapy-experienced, and largely virologically suppressed adults had microalbuminuria. Hence, although the high-risk APOL1 genotype was less prevalent than expected, it was strongly associated with some level of albuminuria.

Keywords: HIV; Nigeria; apolipoprotein 1; glomerular filtration rate; kidney disease; microalbuminuria.

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Figures

Figure 1:
Figure 1:
Study Participant Enrolment Scheme.
Figure 2:
Figure 2:. Risk Allele Distribution by Ethnicity
NB: Color is required for this figure in print.
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