Age-Related Variations in Clinical and Biochemical Profiles of People Living With HIV

People living with HIV (PLHIV) are at increased risk of liver and kidney dysfunction due to chronic HIV infection, long-term antiretroviral therapy (ART), and persistent immune activation. However, age-related differences in organ function and treatment outcomes remain insufficiently characterized in African settings. This study aimed to assess age-related differences in liver and renal function among PLHIV in Ghana to identify patterns of organ dysfunction across different age groups. This multicenter cross-sectional study included 558 PLHIV aged 10-76 years receiving ART, of whom 96.4% were on dolutegravir-based regimens. Renal function was assessed using serum urea, creatinine, urea-to-creatinine ratio, and estimated glomerular filtration rate (eGFR). Liver function was assessed using AST/ALT ratios, hepatotoxicity grading, and fibrosis indices (APRI, FIB-4), while virologic outcomes were assessed using HIV viral load measurements. A composite renal-hepatic-virologic abnormality score was developed based on reduced kidney function (eGFR < 60 mL/min/1.73 m²), elevated AST/ALT ratio (> 1), and unsuppressed viral load (≥ 1000 copies/mL). Data were analyzed using STATA, with p < 0.05 considered statistically significant. Renal, hepatic, and virologic parameters showed significant variation across age groups. Older participants, particularly those aged ≥ 60 years, had lower mean eGFR values (60.32 ± 17.17 mL/min/1.73 m²; p < 0.001), while adolescents aged 13-19 years had the highest frequency of virological failure (22.22%; p < 0.001). The composite renal-hepatic-virologic abnormality score differed significantly across age groups (p < 0.001), with adolescents aged 13-19 years having higher odds of a greater abnormality score compared with children aged ≤ 12 years (aOR = 3.15, 95% CI: 1.23-8.08; p = 0.017). In conclusion, age-related differences were observed in renal, hepatic, and virologic abnormalities among PLHIV in Ghana. These findings support the need for age-tailored biochemical monitoring and further longitudinal studies to clarify temporal relationships between aging and organ function in PLHIV.