Extra Care of Kidneys Vital for People With HIV

The people living with HIV (PLHIV), particularly those who are on the antiretroviral therapy (ART) consisting of tenofovir drug, should take extra-care of their kidneys. This was another key learning for me personally at the recently concluded Chennai ART Symposium (CART 2011).

CART 2011 was organized in Chennai, India (8-9 January 2011) by Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE), in collaboration with Centre for AIDS Research (CFAR), Brown University, National Institute of Health (NIH), University of California (San Diego), Karolinska Institute, and HIV Medicine Association of India (HIVMAI).

Renal (kidney-related) toxicities and HIV was another key concern raised at CART 2011 by Dr. Karen T Tashima, Associate Professor of Medicine, Alpert Medical School of Brown University.

Speaking on the key risk factors that can exacerbate renal toxicities associated with HIV, Dr. Tashima listed diabetes, high blood pressure (BP), kidney stones, inflammation, allergic reactions to medications (example antibiotics), overuse of painkillers (like NSAIDS), drug abuse, use of creatinine or testosterone among others – are the prime reasons that can up the risk of kidney-related health issues among PLHIV.

What can national AIDS programmes do to prevent renal toxicities among PLHIV particularly those who are on ART with tenofovir as one of the drugs? Dr. Tashima suggests that renal functions (kidney functions) should be evaluated in all people living with HIV (PLHIV).

I don’t buy the argument that weak health systems cannot deliver this integrated and holistic treatment and care for all PLHIV. Look at the cost of and the high level to which existing health systems are over-burdened if not crumbling with preventable or avoidable conditions or co-morbidities. Taking good care of kidneys, other co-infections and co-morbidities will probably yield much higher outcomes in terms of public health.

Dr. Tashima adds another merit to evaluating renal functions regularly among PLHIV particularly those on ART with tenofovir as one of the drugs. Dr. Tashima said that renal or kidney dysfunction can be improved among PLHIV by starting HAART (highly active ART), as per the results of studies like SMART and DART.

Hope India’s National AIDS Control Organization (NACO) and other public and private health agencies are listening – and synergise so as to deliver holistic and comprehensive healthcare to all – including PLHIV. (CNS)