ABSTRACT

Aim: To study the clinical manifestation of renal involvement of HIV patients and its correlation with virologic load and CD4 T- cell count, with correlation with cystatin –c as early biomarker of renal involvement in HIV patients. Methodology: Sample of 75 known retro-positive cases who attended Dr DY Patil medical college and hospital, DY Patil Vidyapeeth, Pimpri, Pune during the study period were selected. All procedures and interventions have been established only after obtaining adequate / appropriate consent in a prescribed form. Ethical clearance has been obtained from the Ethical clearance committee in a prescribed certificate. Results: The spectrum of HIVAN manifests ions are equally distributed among male and female population. dipstick proteinuria is the most effective measure for screening of the patients for renal manifestations in patients with HIV. the significant proteinuria with >1+ on dipstick examination in patient with all other causes excluded (hypertension, diabetes mellitus) should always warrant for further investigation. 24 hour urinary and >3gm/dl spot Upcr >3.5gm/dl were more associated with HIVAN. Duration of ART doesn’t have any correlation with the renal disease or proteinuria if patient maintains good immunological status (CD4+-T –cells >500/microL) with good adherence to the HAART. The low CD4+T - cells is associated with the early onset of renal manifestation with most values below <200 cells /microL ,and poor adherence or lack of use of HAART ,as studies have revealed that the HIV virus stimulates the PODOCYTES to differentiate and podocytopathy is the hallmark of HIVAN and cause of proteinuria. Conclusion: Hence urinary cystatin -c which is marker of tubular dysfunction is early marker of renal disease in HIVAN patients even before the onset of nephrotic proteinuria. Keywords: HIV, Cystatin, HAART, CD+4, Podocytopathy, ART
Publication date: 15/02/2022

https://ijbpas.com/pdf/2022/February/MS_IJBPAS_2022_FEB_SPCL_1046.pdf

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https://doi.org/10.31032/IJBPAS/2022/11.2.1046