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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays

Published on: September 26, 2011

APOL1 Genotype and HIV Infection: 20-Year Outcomes for CKD, Cardiovascular Disease, and Hypertension

Katherine K Tassiopoulos1, Kunling Wu2, Zhenzhen Wu3

  • 1Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.

Kidney International Reports
|April 14, 2025
PubMed

Insights

APOL1 risk alleles increase chronic kidney disease (CKD) risk in Black individuals with HIV. While not linked to hypertension or cardiovascular disease (CVD), APOL1 impacts kidney function over time, especially without viral suppression.

Area of Science:

  • Genetics and Genomics
  • Nephrology
  • Infectious Diseases

Background:

  • APOL1 variant alleles are a significant risk factor for chronic kidney disease (CKD) in individuals of Black African ancestry.
  • The impact of APOL1 risk alleles on hypertension and cardiovascular disease (CVD) in this population, particularly those with HIV, remains incompletely understood.

Purpose of the Study:

  • To investigate the association between APOL1 risk alleles and the incidence of CKD, hypertension, and CVD in Black individuals with HIV.
  • To examine the longitudinal effects of APOL1 genotype on estimated glomerular filtration rate (eGFR) and proteinuria.
  • To evaluate the role of HIV-1 viral suppression as a modifier of these associations.

Main Methods:

  • Genotyping for APOL1 risk alleles in a cohort of 1194 Black individuals with HIV from ACTG studies A5001 and A5322.
  • Utilizing Cox proportional hazard models to assess associations with incident CKD, CVD, and hypertension.
  • Employing linear mixed effects models for longitudinal analysis of eGFR and proteinuria, with HIV-1 viral suppression as a potential effect modifier.

Main Results:

  • APOL1 genotype was significantly associated with CKD incidence but not with hypertension or CVD.
  • Individuals with APOL1 risk alleles exhibited greater annual rates of eGFR decline and increased proteinuria, with a notable effect of a single risk allele emerging after ten years.
  • Sustained HIV-1 viral suppression did not alter the CKD-APOL1 association but was linked to slower eGFR decline and reduced proteinuria in participants with APOL1 risk alleles.

Conclusions:

  • Among treated individuals with HIV, APOL1 risk alleles are linked to CKD and accelerated eGFR decline, with poorer outcomes in those lacking sustained viral suppression.
  • No association was detected between APOL1 risk alleles and incident hypertension or CVD in this cohort.
  • The findings underscore the critical role of APOL1 in HIV-associated nephropathy and highlight the protective effect of viral suppression on kidney function in at-risk individuals.
Abstract

Keywords:
APOL1HIV infectionagingcardiovascular diseasechronic kidney diseasehypertension

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