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Review
. 2023 Mar 1;18(2):87-92.
doi: 10.1097/COH.0000000000000784. Epub 2022 Dec 28.

Host factors predisposing to kidney disease in people with HIV

Rachel K Y Hung  1 , Cheryl A Winkler  2 , Frank A Post  1   3
Affiliations
Review

Host factors predisposing to kidney disease in people with HIV

Rachel K Y Hung et al. Curr Opin HIV AIDS. .

Abstract

Purpose of review: To highlight advances in understanding of host factors, in particular host genetics, in the development of chronic kidney disease (CKD) in people with HIV.

Recent findings: In Black populations, the G1 and G2 variants of the apolipoprotein L1 (APOL1) gene predispose to HIV-associated nephropathy (HIVAN). The risk of HIVAN is mostly confined to individuals with two APOL1 variants (kidney-risk genotypes). APOL1 kidney-risk genotypes are present in approximately 80% of patients with HIVAN and account for nearly half the burden of end-stage CKD in people of African ancestry with HIV. Progress has been made in elucidating the mechanisms of kidney injury in APOL1 nephropathy, and several targeted molecular therapies are being investigated in clinical trials. Genome- and epigenome-wide association studies are identifying additional genes and pathways that may be involved in the pathogenesis of CKD in people with HIV.

Summary: Genetic variants of APOL1 are strongly associated with severe CKD and contribute to the high rates of CKD in Black populations with HIV. Most individuals with APOL1 kidney-risk genotypes, however, do not develop kidney disease and further studies are required to understand the role of additional genetic and environmental factors that may affect CKD risk in this population.

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References

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    1. Hung RKY, Santana-Suarez B, Binns-Roemer E, et al. The epidemiology of kidney disease in people of African ancestry with HIV in the UK. EClinicalMedicine 2021; 38:101006.

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