Interaction of sex and HIV infection on renal impairment: baseline evidence from the CHART cohort. (March 2022)

• Record Type: Journal Article
• Authors: Shi, Ruizi; Chen, Xiaoxiao; Lin, Haijiang; Shen, Weiwei; Xu, Xiaohui; Zhu, Bowen; Xu, Xiaoyi; Ding, Yingying; He, Na
• Is Part Of: International journal of infectious diseases. Volume 116(2022)
• Page Start: 182
• Page End: 188
• Publication Date: 2022-03
• Subjects: HIV -- sex -- interaction -- renal impairment -- eGFR; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.01.010
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: The prevalence of renal impairment (RI) in people living with HIV (PLWH) was comparable with that in HIV-negative individuals overall The prevalence of RI was higher in HIV-positive females than in HIV-negative females. Sex-specific correlates of RI were observed in all participants. HIV infection and sex may act synergistically on RI through fat metabolism. Abstract: Objective: Females are more vulnerable to renal impairment (RI) in people living with HIV (PLWH), but few studies have examined sex disparity in the association of HIV serostatus with RI. Methods: In total, 2, 101 PLWH on antiretroviral treatment (ART) and 4, 202 HIV-negative people were selected and frequency matched in 1:2 ratio by sex and age categories. RI was defined as estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m 2 . The interaction effect of sex with HIV serostatus and correlates of RI were assessed by logistic regression models. Results: In total, 78.2% of participants were males with median age 43.7 (IQR: 32.5-54.4) years. The prevalence of RI was comparable for PLWH and HIV-negative people overall (30.4% vs 30.1%) but significantly higher for HIV-positive females (37.1%) than HIV-negative females (30.1%). Multiple logistic regression identified an interaction between sex and HIV serostatus on RI (adjusted odds ratio [aOR] of the interaction term: 1.66, 95% CI: 1.23-2.26). HIV infection was significantly associated with RI in females (aOR: 1.55, 95% CI: 1.17-2.06) but not in males. Central obesity and nadir CD4 count were significantly associated with RI in HIV-infected females but not in HIV-infected males. Conclusions: Sex seems to modify the association between HIV infection and RI, suggesting a sex-specific mechanistic pathogenesis of RI in PLWH, which warrants further investigation and intervention.