A STUDY OF RENAL ABNORMALITIES IN HIV INFECTED PATIENTS AND ITS CORRELATION WITH CD4 COUNT AND ART REGIMEN

Renal disease is a recognized complication of HIV infection, with chronic kidney disease (CKD) prevalence reported between 3.5% and 32.6%. Tenofovir disoproxil fumarate (TDF) has been associated with nephrotoxicity, and lower CD4 counts are linked to higher risk of renal impairment. Early identification of renal dysfunction in HIV-positive individuals is critical for timely intervention. Objectives: To determine the prevalence of renal damage in the form of proteinuria and reduced creatinine clearance/eGFR in HIV-infected patients, and to assess its correlation with antiretroviral therapy (ART) regimen and CD4 T-cell count. Methods: This cross-sectional observational study included 300 HIV-positive patients (aged 18–70 years) attending a tertiary care hospital. Data collected included demographics, ART regimen, CD4 count, urine analysis, 24-hour urine protein, and renal function tests. Creatinine clearance (Cockcroft–Gault) and eGFR (MDRD) were calculated. Patients were categorized based on ART regimen (TDF-based vs. zidovudine [AZT]-based) and CD4 count (<200, 200–350, >350 cells/µl). Results: Of 300 patients, 196 (65.33%) were male; mean age was ~39 years. TDF-based regimen was used in 158 (52.6%) patients, AZT-based in 120 (40%), and 22 (7.3%) were not on ART. Proteinuria was present in 24% of patients, significantly higher in the TDF group (88.9%) than AZT group (13.8%) (p<0.05). Conclusion: Proteinuria and reduced renal function are common among HIV-infected patients, particularly in those on TDF-based regimens and with CD4 counts <200 cells/µl. Regular renal function monitoring is recommended at diagnosis and quarterly for patients on TDF or with advanced HIV disease.