Chronic Kidney Disease among Human Immunodeficiency Virus Positive Patients on Antiretroviral Therapy in Sub-Saharan Africa: A Systematic Review and Meta-analysis

Abstract

ABSTRACT. Human immunodeficiency virus (HIV)-infected patients are at risk for renal disease as a consequence of complications of antiretroviral treatment. Particularly, the complication of kidney disease is high in patients who switched to Tenofovir Disoproxil Fumarate. The treatment is associated with nephrotoxicity, decrease in glomerular filtration rate, leading to kidney disease. This review focused on assessing the effect of antiretroviral therapy (ART) on kidney function among HIV-positive patients. Initially, the study protocol was registered on Prospero and given a unique identification number of CRD42018087686. We then conducted a systematic search of PubMed, Google Scholar, the Cochrane library, and Google from 2008 to September 2018. We found 742 study results eligible for this review. After stringent filtration mechanism, 15 qualified studies were used for systematic review and meta-analysis process. Cross-sectional, cohort, randomized controlled trials, and prospective studies were eligible for inclusion in the study. The overall pooled prevalence found in this meta-analysis was 6.42% with high statistical heterogeneity (I2 = 96.7%). The highest subgroup prevalence was reported from Ghana, with subgroup prevalence of 13.65% without statistical heterogeneity (I2 = 0.0%). Majority of chronic kidney disease (CKD) was in stage 3 with subgroup prevalence of 6.78% and tolerable statistical heterogeneity (I2 = 66.7%). There was high pooled prevalence of CKD among HIV-positive patients on ART in Sub-Saharan Africa. The highest subgroup prevalence was reported from Ghana. Majority of CKD was reported in stage 3.