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04 Aug 2024 | FEATURE ARTICLE
Ghana's Hidden Epidemic: A Link Between HIV and Kidney Disease
By Yakubu Adam
The intersection of HIV and kidney disease is a growing concern in Ghana, reflecting a broader trend observed across Sub-Saharan Africa. As the country battles the HIV epidemic, the long-term complications of the virus, including its impact on renal health, are becoming increasingly evident. This article delves into how HIV facilitates kidney disease in Ghana, the underlying mechanisms, and potential pathways forward.
Ghana has made significant strides in combating HIV/AIDS, with adult prevalence rates stabilizing around 1.7% as of recent estimates (Ghana AIDS Commission, 2022). Despite these efforts, the number of people living with HIV remains substantial. Advances in antiretroviral therapy (ART) have improved life expectancy and quality of life for many, but these advancements come with new health challenges, including an increased risk of kidney disease.
Research indicates several pathways through which HIV can lead to kidney disease. HIV-associated nephropathy (HIVAN) is a direct consequence of the virus infecting kidney cells. This condition is more prevalent in individuals of African descent, highlighting a genetic susceptibility (Lucas et al., 2020). HIVAN can lead to rapid kidney failure if not managed properly. While lifesaving, certain antiretroviral drugs can be nephrotoxic. Tenofovir, for example, has been linked to kidney damage in some patients (Bygrave et al., 2011). The chronic use of these medications necessitates regular monitoring of renal function. HIV disrupts the immune system, leading to chronic inflammation. This persistent immune activation can damage various organs, including the kidneys, over time (Atta et al., 2014). Additionally, HIV-positive individuals are at higher risk for other infections and conditions, such as hepatitis B and C, diabetes, and hypertension, all of which can adversely affect kidney health (Kalayjian, 2010).
A study conducted by the University of Ghana Medical School in collaboration with international partners revealed alarming trends. The research, which involved over 1,200 HIV-positive patients, found that approximately 20% had some form of kidney impairment (Osafo et al., 2013). The study also highlighted that patients with longer HIV durations and those on specific ART regimens had higher rates of kidney disease. Another significant study published in the Journal of the International AIDS Society noted that African patients, including Ghanaians, have a genetic predisposition to HIVAN due to a higher prevalence of the APOL1 gene variant, which increases the risk of kidney disease in the presence of HIV (Winston et al., 2008).
Given the complexity of HIV-related kidney disease, a multifaceted approach is essential. Regular renal function tests should be integrated into the routine care of HIV-positive patients. Early detection of kidney impairment can lead to timely interventions and better outcomes (Szczech et al., 2002). Health practitioners should consider the renal side effects of ART drugs and opt for less nephrotoxic options when possible. Continuous research and development of safer medications are crucial. Healthcare providers need ongoing training to recognize and manage HIV-related kidney diseases. Public health campaigns can also raise awareness about the risks and promote healthy practices.
Continued research is vital to understand the full scope of the problem and to develop targeted interventions. Data collection should include a focus on genetic factors, comorbid conditions, and long-term outcomes of patients with HIV-related kidney disease (Fabian et al., 2013). The government and international organizations must prioritize kidney health within the broader HIV/AIDS strategy. Increased funding for kidney disease research, prevention, and treatment is necessary to address this emerging crisis effectively.
In conclusion, the relationship between HIV and kidney disease presents a significant public health challenge in Ghana. As the nation continues to combat HIV, it must also address the long-term health complications associated with the virus. Through early detection, optimized treatment regimens, education, research, and robust policy support, Ghana can mitigate the impact of kidney disease among its HIV-positive population and improve overall health outcomes. Source :
Yakubu Adam
Toxicologist
Forensic Investigation for National Development-Ghana (FIND-GH) REFERENCES
Atta, M. G., Gallant, J. E., & Rahman, M. H. (2014). HIV-1 and the kidney. Continuum (Minneap Minn), 20(5 Infectious Disease), 1305-1322.
Bygrave, H., Ford, N., van Cutsem, G., Hilderbrand, K., Jouquet, G., Goemaere, E., ... & Bedelu, M. (2011). Implementing a tenofovir-based first-line regimen in rural Lesotho: clinical outcomes and toxicities after two years. Journal of Acquired Immune Deficiency Syndromes (1999), 56(3), e75-e78.
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Source: Modern Ghana
https://www.modernghana.com/news/1332078/ghanas-hidden-epidemic-a-link-between-hiv-and.html
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