The Impact of HAART on Kidney Function in HIVAIDS Patients

Highly Active Antiretroviral Therapy (HAART) has brought improvement in the management of HIV/AIDS, significantly reducing morbidity and mortality. However, emerging evidence indicates that HAART may have complex effects on kidney function in HIV-positive individuals. We reviewed the impact of HAART on renal function, examining both its protective and potentially nephrotoxic effects. HIV-associated nephropathy (HIVAN) is a known complication of uncontrolled HIV infection, and HAART has been shown to delay its progression by suppressing viral replication. Conversely, some antiretroviral drugs, particularly tenofovir disoproxil fumarate (TDF), indinavir, and certain protease inhibitors have been linked to nephrotoxicity, manifesting as proximal tubular dysfunction, reduced glomerular filtration rate (GFR), and, in some cases, acute kidney injury (AKI). The role of comorbid conditions such as hypertension, diabetes, and co-infection with hepatitis B or C have been reported in the literatures. Findings suggest that while HAART contributes to overall renal preservation by controlling HIV replication, the risk of kidney impairment persists, particularly with prolonged exposure to nephrotoxic agents and in individuals with pre-existing renal conditions. Tailored antiretroviral regimens and regular renal monitoring are essential to mitigate these risks. Understanding the dual role of HAART in kidney health can help optimize treatment protocols and improve long-term outcomes for people living with HIV/AIDS.