Renal Function Impairment in People Living with HIV: An Integrative Literature Review
Renal Function Impairment in People Living with HIV
Keywords:
Anti-HIV drugs, AIDS-associated nephropathy, HIV seropositivityAbstract
With advances in antiretroviral treatment, HIV infection is no longer considered a fatal condition and is now managed as a chronic disease. However, prolonged use of antiretroviral therapy, combined with coinfections, aging, and metabolic comorbidities, has increased the incidence of renal complications. This study aimed to analyze, through an integrative literature review, the impacts of antiretroviral therapy on renal function in people living with HIV, in addition to raising awareness among healthcare professionals about the judicious use of potentially nephrotoxic drugs, especially those prescribed in dentistry, given that these patients already have strained renal function. The search was conducted in the Virtual Health Library (VHL), including publications from the last five years related to the interaction between HIV, drug treatment, and renal impairment. Analysis of 15 articles showed that tenofovir disoproxil fumarate is one of the drugs most implicated in nephrotoxicity, associated with tubular loss and progression to chronic kidney disease. Factors such as advanced age, comorbidities, coinfections, and genetic variants increase vulnerability to such complications. It is concluded that the clinical management of these patients requires continuous monitoring of renal function, rational selection of therapeutic regimens, and cautious prescription of routine medications, such as dental medications, in order to reduce risks and improve clinical outcomes.
Downloads
References
BONNET, Fabrice et al. Evolution of comorbidities in people living with HIV between 2004 and 2014: cross-sectional analyses from ANRS CO3 Aquitaine cohort. BMC Infectious Diseases, London, v. 20, n. 850, 2020. Disponível em: . Acesso em: 17 jul. 2025.
CERVANTES, C. Elena; ATTA, Mohamed G. Updates on HIV and kidney disease. Current HIV/AIDS Reports, New York, v. 20, n. 2, p. 100–110, abr. 2023. Disponível em: . Acesso em: 17 jul. 2025.
CUSATO, Jessica et al. Pharmacogenetic determinants of kidney-associated urinary and serum abnormalities in antiretroviral-treated HIV-positive patients. The Pharmacogenomics Journal, London, v. 19, n. 6, p. 526–540, 2019. Disponível em: https://doi.org/10.1038/s41397-019-0109-x. Acesso em: 17 jul. 2025.
HERON, Jack Edward; BAGNIS, Corinne Isnard; GRACEY, David M. Contemporary issues and new challenges in chronic kidney disease amongst people living with HIV. AIDS Research and Therapy, London, v. 17, n. 11, 2020. Disponível em: https://doi.org/10.1186/s12981-020-00266-3. Acesso em: 17 jul. 2025.
KUDOSE, Satoru et al. The spectrum of kidney biopsy findings in HIV-infected patients in the modern era. Kidney International, London, v. 97, n. 5, p. 1006–1016, 2020. Disponível em: . Acesso em: 17 jul. 2025.
LEI, Wei et al. A novel mu-delta opioid agonist demonstrates enhanced efficacy with reduced tolerance and dependence in mouse neuropathic pain models. Journal of Pain, London, v. 21, n. 1–2, p. 146–160, 2020. Disponível em: . Acesso em: 17 jul. 2025.
LUCAS, Anika; WYATT, Christina M. HIV at 40: kidney disease in HIV treatment, prevention, and cure. Kidney International, London, v. 102, n. 4, p. 740–749, out. 2022. Disponível em: https://doi.org/10.1016/j.kint.2022.06.021. Acesso em: 17 jul. 2025.
MA, Jie et al. The spectrum of kidney biopsy findings in Chinese HIV-infected patients. HIV Medicine, London, v. 23, supl. 1, p. 23–31, 2022. Disponível em: https://doi.org/10.1111/hiv.13246. Acesso em: 17 jul. 2025.
MELLIEZ, Hugues et al. Risk of severe bacterial infection in people living with HIV in the combined antiretroviral therapy era. The Journal of Infectious Diseases, London, v. 222, n. 5, p. 765–776, 2020. Disponível em: . Acesso em: 17 jul. 2025.
MULLER, Elmi et al. Kidney transplantation in HIV-positive patients: current practice and management strategies. Transplantation, London, v. 105, n. 7, p. 1492–1501, 2021. Disponível em: https://doi.org/10.1097/TP.0000000000003485. Acesso em: 17 jul. 2025.
NAICKER, Saraladevi. HIV/AIDS and chronic kidney disease. Clinical Nephrology, München, v. 93, supl. 1, p. S87–S93, 2020. Disponível em: https://doi.org/10.5414/CNP92S115. Acesso em: 17 jul. 2025.
NEARY, M. D. et al. Do genetic variations in proximal tubule transporters influence tenofovir-induced renal dysfunction? An exploratory study in a Ghanaian population. Journal of Antimicrobial Chemotherapy, London, v. 75, p. 1267–1271, 2020. Disponível em: https://doi.org/10.1093/jac/dkaa008. Acesso em: 17 jul. 2025.
PONTES, Priscila Silva et al. Fatores associados à doença renal crônica em pessoas vivendo com HIV/AIDS. Revista Latino-Americana de Enfermagem, Ribeirão Preto, v. 28, p. e3331, 2020. Disponível em: http://dx.doi.org/10.1590/1518-8345.3553.3331. Acesso em: 17 jul. 2025.
REGHINE, Érica Lofrano; FORESTO, Renato Demarchi; KIRSZTAJN, Gianna Mastroianni. HIV-related nephropathy: new aspects of an old paradigm. Revista da Associação Médica Brasileira, São Paulo, v. 66, supl. 1, p. S75–S81, 2020. Disponível em: . Acesso em: 17 jul. 2025.
WEARNE, Nicola; DAVIDSON, Bianca V. HIV-associated kidney disease: the changing spectrum and treatment priorities. Current Opinion in Nephrology and Hypertension, London, v. 33, n. 6, p. 603–612, nov. 2024. Disponível em: . Acesso em: 17 jul. 2025.
