Renal Risk Variants and Kidney Function in HIV-1-Infected People From Sub-Saharan Africa.

Introduction: G1 and G2 alleles have been associated with kidney-related outcomes in people living with HIV (PLHIV) of Black African origin. No APOL1-related kidney risk data have yet been reported in PLHIV in West Africa, where high allele frequencies have been observed.

Methods: We collected clinical data from PLHIV followed in Burkina Faso ( = 413) and in the ANRS-12169/2LADY trial (Cameroon, Senegal, Burkina Faso,  = 369). G1 and G2 risk variants were genotyped using TaqMan assays, and high-risk (HR) genotype was defined by the carriage of 2 risk alleles.

Results: In West Africa (Burkina Faso and Senegal), the G1 and G2 allele frequencies were 13.3% and 10.7%, respectively. In Cameroon (Central Africa), G1 and G2 frequencies were 8.7% and 8.9%, respectively. HR prevalence was 4.9% in West Africa and 3.4% in Cameroon. We found no direct association between HR and estimated glomerular filtration rate (eGFR) change over time. Nevertheless, among the 2LADY cohort participants, those with both HR and high baseline viral load had a faster eGFR progression (β = -3.9[-7.7 to -0.1] ml/min per 1.73 m per year,  < 0.05) than those with low-risk (LR) genotype and low viral load.

Conclusion: Overall, the risk allele frequencies in PLHIV were higher in the West African countries than in Cameroon, but much lower than previously reported in some Nigeria ethnic groups, which strongly advocates for further investigation in the African continent. This study suggested that the virological status could modulate the impact on kidney function, hence reinforcing the need for early therapeutic interventions.