HIV and Associated TB: A Lethal Association for Kidney Health?
Robert Kalyesubula1, Nicola Wearne2, Mary Kubo3
1Department of Physiology and Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Seminars in Nephrology
|January 20, 2024
Summary
Human immunodeficiency virus (HIV) and tuberculosis (TB) coinfection significantly impacts kidney health, particularly in low-income nations. Effective management strategies are crucial to mitigate kidney disease progression and improve patient outcomes.
Area of Science:
- Global health
- Infectious diseases
- Nephrology
Background:
- Human immunodeficiency virus (HIV) and tuberculosis (TB) are leading global infectious causes of mortality.
- HIV/TB coinfection disproportionately affects low- and middle-income countries, causing severe kidney damage and accelerated decline in kidney function.
- Managing the complex interplay of TB, HIV, and kidney disease presents significant clinical challenges.
Purpose of the Study:
- To review the epidemiology of HIV/TB coinfection and its impact on kidney disease.
- To explore the mechanisms, clinical presentation, and diagnostic challenges of kidney disease in coinfected patients.
- To outline prevention and management strategies for HIV/TB-related kidney disease.
Main Methods:
- Literature review and synthesis of existing research on HIV/TB coinfection and kidney disease.
- Discussion of epidemiological data, pathogenic mechanisms, and clinical manifestations.
- Exploration of diagnostic hurdles and therapeutic interventions.
Main Results:
- HIV/TB coinfection accelerates kidney function decline and increases mortality.
- Genetic susceptibility plays a role in HIV/TB-related kidney disease.
- Challenges exist in diagnosing chronic kidney disease (CKD) in this population.
Conclusions:
- HIV/TB coinfection elevates kidney-related morbidity and mortality risks.
- Special consideration for research and management is imperative for patients with HIV/TB coinfection and kidney disease.
- Preventive measures include careful assessment, avoiding nephrotoxic drugs, dose adjustments, and monitoring.
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