Efeitos do vírus da Imunodeficiência Humana (HIV) em biomarcadores vasculares e lesão podocitária: estudo transversal com pacientes HIV não tratados

Abstract

HIV infection is related with diverse kinds of kidney disease, including HIV direct effects. Early and differential diagnosis of kidney damage may avoid poor outcomes associated with kidney disease. This study aims to evaluate impacts of elevated viral load in endothelial system and podocyte cells of untreated HIV patients. Methods: Untreated HIV patients without previous kidney disease were included. Routine laboratory parameters were collected, such as viral load, CD4 count and other laboratory data. Kidney function was evaluated using serum creatinine and estimated glomerular filtration rate. Urinary nephrin, and vascular biomarkers (VCAM-1, angiopoietin-2 and syndecan-1) were quantified by ELISA assays. Untreated HIV patients were divided into three groups according to quartiles of viral load. Results: Untreated HIV patients group with higher viral load quartile had more frequent presence of nephrinuria than other quartiles (75 vs 11%, p<0,001). VCAM-1 and angiopoietin-2 were higher in higher viral load group. In correlations analysis, syndecan-1 and angiopoietin-2 were correlated with increased viral load. Also, angiopoietin-2 was correlated with decreased CD4 count. Conclusion: untreated HIV patients with elevated viral load had glomerular filtration barrier dysfunction even in clinical normal kidney function. Vascular dysfunction was associated with elevated viral load and may contribute indirectly for a glomerular dysfunction progression. It present results reinforces the importance to initiate antiretroviral treatment as soon as possible to avoid clinical complications such as kidney disease.