Patients infectés par le virus de l’immunodéficience humaine suivis en néphrologie : caractéristiques de la cohorte bordelaise

Abstract : Introduction: the epidemiology of kidney disease in patients with human immunodeficiency virus (HIV) has been drastically changed by highly active antiretroviral therapy (HAART). The aim of our study is to analyze the epidemiology of kidney disease and the prognostic factors of kidney disease progression in the population of HIV patients in Bordeaux. Methods: we assessed a retrospective single center cohort study. All patients with HIV starting a follow-up in nephrology department of the teaching hospital of Bordeaux, between 2007 and 2014 were included in our study. Patients were then classified in 4 groups according to kidney disease type. Results: 204 patients were included in this study: 47 in the group “glomerulopathy”, 102 in the group “tubulopathy”, 20 in the group “mixed nephropathy” and 35 in the group “no kidney disease”. Majority of patients had a controlled viral disease. The most frequent glomerulopathies were hypertensive kidney disease and diabetic glomerulopathy (61,1 %). HIV associated nephropathy (HIVAN) and HIV immune complex kidney disease (HIVICD) represented only 11.9 % of diagnosis. Tubulopathies were mainly represented by the Fanconi syndrome induced by tenofovir disoproxil fumarate (55.7 %). In univariate analysis, patients with glomerulopathy had a worse vital and renal outcome compared to the group without nephropathy (HR = 2.36; CI95 = 1.04-5.37) after a median follow-up of 45 months. There was no difference in multivariate analysis. In the whole population, factors associated with a bad outcome were age (HR: 1.06 per additional year; CI95: 1.01 – 1.11; p=0.009) and proteinuria (HR: 1.41 per additional gram; CI95: 1.08 – 1.85; p=0.01). Conclusion: we described epidemiology of kidney disease in a French cohort of patients with HIV followed in nephrology department. Except the iatrogenic tubulopathy, the epidemiology of kidney disease is close to general population.
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Master Thesis
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Simon Mucha. Patients infectés par le virus de l’immunodéficience humaine suivis en néphrologie : caractéristiques de la cohorte bordelaise. Médecine humaine et pathologie. 2017. ⟨dumas-01651147⟩

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