Interaction of sex and HIV infection on renal impairment: baseline evidence from the CHART cohort

Ruizi Shi; Xiaoxiao Chen; Haijiang Lin; Weiwei Shen; Xiaohui Xu; Bowen Zhu; Xiaoyi Xu; Yingying Ding; Na He

doi:10.1016/j.ijid.2022.01.010

Interaction of sex and HIV infection on renal impairment: baseline evidence from the CHART cohort

Int J Infect Dis. 2022 Mar:116:182-188. doi: 10.1016/j.ijid.2022.01.010. Epub 2022 Jan 10.

Authors

Ruizi Shi¹, Xiaoxiao Chen², Haijiang Lin³, Weiwei Shen², Xiaohui Xu¹, Bowen Zhu¹, Xiaoyi Xu¹, Yingying Ding¹, Na He⁴

Affiliations

¹ School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
² Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China.
³ School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China.
⁴ School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Shanghai Institute of Infectious Diseases and Biosecurity, Fudan University, Shanghai, China; Yi-Wu Research Institute, Fudan University, Shanghai, China. Electronic address: nhe@fudan.edu.cn.

PMID: 35017104
DOI: 10.1016/j.ijid.2022.01.010

Abstract

Objective: Females are more vulnerable to renal impairment (RI) in people living with HIV (PLWH), but few studies have examined sex disparity in the association of HIV serostatus with RI.

Methods: In total, 2,101 PLWH on antiretroviral treatment (ART) and 4,202 HIV-negative people were selected and frequency matched in 1:2 ratio by sex and age categories. RI was defined as estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m². The interaction effect of sex with HIV serostatus and correlates of RI were assessed by logistic regression models.

Results: In total, 78.2% of participants were males with median age 43.7 (IQR: 32.5-54.4) years. The prevalence of RI was comparable for PLWH and HIV-negative people overall (30.4% vs 30.1%) but significantly higher for HIV-positive females (37.1%) than HIV-negative females (30.1%). Multiple logistic regression identified an interaction between sex and HIV serostatus on RI (adjusted odds ratio [aOR] of the interaction term: 1.66, 95% CI: 1.23-2.26). HIV infection was significantly associated with RI in females (aOR: 1.55, 95% CI: 1.17-2.06) but not in males. Central obesity and nadir CD4 count were significantly associated with RI in HIV-infected females but not in HIV-infected males.

Conclusions: Sex seems to modify the association between HIV infection and RI, suggesting a sex-specific mechanistic pathogenesis of RI in PLWH, which warrants further investigation and intervention.

Keywords: HIV; eGFR; interaction; renal impairment; sex.

MeSH terms

Adult
Anti-Retroviral Agents / therapeutic use
CD4 Lymphocyte Count
Cohort Studies
Female
HIV Infections* / complications
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Humans
Male
Renal Insufficiency* / epidemiology
Renal Insufficiency* / etiology

Substances

Anti-Retroviral Agents