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Apolipoprotein L1 gene variants and kidney disease in patients with HIV: a systematic review and meta-analysis
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Apolipoprotein L1 gene variants and kidney disease in patients with HIV: a systematic review and meta-analysis
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Apolipoprotein L1 gene variants and kidney disease in patients with HIV: a systematic review and meta-analysis
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Journal Article
Apolipoprotein L1 gene variants and kidney disease in patients with HIV: a systematic review and meta-analysis
2023
Overview
Background
The risk of various types of kidney disease is significantly increased in the presence of
APOL1
high-risk genotype (carriage of two risk alleles), particularly HIV-associated nephropathy (HIVAN). However, there are discrepancies in the existing evidence about the level of association between
APOL1
high-risk genotype and the risk of kidney diseases in people living with HIV (PLWHIV).
Methods
This systematic review and meta-analysis was conducted to assess the relationship between the
APOL1
genotypes and kidney disease in the HIV population. An
a priori
protocol registered on PROSPERO (ID: CRD42021253877), was followed by a systematic search of five electronic databases. Database-specific search terms were used to identify observational studies that evaluated the outcomes chosen in the review, based on a set of prespecified eligibility criteria. Using a random effect model, the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were pooled for the meta-analysis.
Results
After screening 4418 citations, 14 articles comprising 11,069 participants were included in this review. The risk of chronic kidney disease (CKD) in the HIV positive population was significantly increased in the presence of two
APOL1
risk alleles (OR 4.65 [95% CI 3.51–6.15]). Also, a significant association was observed between the carriage of two risk
APOL1
variants and proteinuria (OR 2.58 [95% CI 2.05–3.25]), HIVAN (OR 16.67 [95% CI 10.22–27.19]), and progression to end-stage kidney disease (ESKD) hazard ratio: 1.79 (95% CI 1.20–2.66).
Conclusion
This review highlights a strong association between the presence of two risk
APOL1
variants and an increased risk of kidney disease in PLWHIV, and provides a more precise estimate of the effect size, with smaller 95% CIs for CKD, HIVAN, and progression to ESKD.
Publisher
Springer International Publishing,Oxford University Press
Subject
AIDS-Associated Nephropathy - diagnosis
/ AIDS-Associated Nephropathy - genetics
/ Apolipoprotein L1 - genetics
/ Genotype
/ HIV
/ Human immunodeficiency virus
/ Humans
/ Kidney Failure, Chronic - diagnosis
/ Kidney Failure, Chronic - genetics
/ Medicine
/ Renal Insufficiency, Chronic - diagnosis
/ Renal Insufficiency, Chronic - epidemiology
/ Renal Insufficiency, Chronic - genetics
/ Urology
