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Abstract: SA-PO446

Association of APOL1 Risk Variants with Subclinical Renal Disease in HIV Infected Children and Apparently Healthy Children from Central Africa (Democratic Republic of Congo)

Session Information

  • Pediatric Nephrology - II
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Ekulu, Pepe Mfutu, KU Leuven , Leuven, Belgium
  • Aloni, Michel Ntetani, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
  • Lepira, François, University of Kinshasa, Kinshasa, Congo
  • Levtchenko, Elena N., KU Leuven , Leuven, Belgium
Background

Apolipoprotein-L1 (APOL1) risk variants G1 and G2 increase the risk of progressive chronic kidney disease (CKD), including HIV-related CKD, among sub-Saharan African descents. HIV infection, a substantial healthcare problem in sub-Saharan Africa, is an extremely potent trigger factor for APOL1 kidney disease. However, data on APOL1 risk genotypes from Central Africa still remain limited and the association with HIV-related CKD is not yet well documented. We aimed to describe the prevalence of APOL1 risk variants in the Democratic Republic of Congo (DRC) and to assess the association between these variants and the subclinical renal disease in both HIV infected children and apparently healthy children.

Methods

A total of 813 participants, of whom 401 HIV infected children treated with antiretroviral therapy (ART) and 412 apparently healthy children, were enrolled from four large districts in Kinshasa, the capital of the DRC. APOL1 high-risk genotype (HRG) was defined by the presence of 2 risk variants (G1/G1, G2/G2, and G1/G2) and low risk genotype (LRG) if 0 or 1 risk variants were present. As the main outcomes, reduced kidney function was defined as eGFR <60 ml/min per 1.73 m2 and elevated urine albumin-to-creatinine ratio (ACR) ≥ 30mg/g.

Results

From 813 participants, APOL1 sequence analysis revealed 52 (6.4%) carrying HRG. Regarding LRG, 168 (20.6%) participants carried G1/G0 while 116 (14%) carried G2/G0. Of 401 HIV infected children, 72 (18%) had elevated albuminuria versus 40 (9.7%) out of 412 apparently healthy children (p<0.001) and reduced kidney function was detected in 26 (6.5%) against 13 (3.1%) (p=0.019). Considering the association between APOL1 HRG and renal disease, 18/23 (78.3%) HIV infected children carrying HRG had elevated albuminuria (0R 21.6, 95%CI 7.3-76.6; p<0.001) against 5/29 (17.2%) apparently healthy children (0R 2.1, 95%CI 0.6-6.0; p=0.137). No significant difference was found concerning the reduced renal function.

Conclusion

The APOL1 risk variants are highly prevalent in the DRC. The HIV infection is strongly associated with the presence of subclinical renal disease, especially in those carrying the APOL1 HRG.