Gene APOL1 como preditor de doença renal em pacientes com HIV: revisão sistemática

Abstract

Objective: To evaluate the presence of the APOL1 gene and its variants, as genetic predictors of nephropathy, in patients diagnosed with HIV infection. Methods: Systematic review of the literature, according to the systematic review guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group, to assess the prediction of acute kidney injury correlated to the APOL1 gene, in patients infected with the HIV. The formulation of the research question was structured in the format of the acronym PECO, defined by the Ministry of Health. Results: Patients with the genetic risk factor were more likely to have a higher urinary albumin/creatinine ratio (uACR), higher serum creatinine, and lower glomerular filtration rate (eGFR). Also, they were more likely to have persistent macroalbuminuria (uACR >300 mg/g) and eGFR <60 ml/min/1.73 m². The predominant etiologies for reduced eGFR and increased uACR were HIVAN and FSGS, more commonly found in patients with a high-risk genotype. Conclusion: Carriers of the APOL1 gene are more likely to have early kidney disease, and additional HIV infection substantially increases this probability.