Background: Limited evidence informs on the prevalence of chronic kidney disease (CKD) in people living with HIV (PLWH) in South Africa. Thus, this study aimed to determine the prevalence of CKD and its associated risk factors among PLWH within the rural province of Limpopo, South Africa.Methods: We conducted a cross-sectional study of 143 participants, subdivided into groups of PLWH (n = 103) and individuals without HIV (n = 43). Structured questionnaires were used to collect and capture sociodemographic information including age, sex, alcohol intake, smoking status, and educational status. Basic measurements taken included levels of cluster of differentiation 4 (CD4+) count, body mass index (BMI), blood pressure, plasma cystatin C, and fasting serum glucose levels. Plasma cystatin C-based estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) estimator to determine the prevalence of CKD.Results: The prevalence of CKD was approximately 7% in PLWH. Multivariate logistic regression analysis showed that it was only diabetes mellitus (odds ratio of 5.795, 95% confidence interval, p = 0.034) and age (odds ratio of 1.078, 95% confidence interval, p = 0.039) that were significantly associated with CKD in PLWH.Conclusion: Chronic kidney disease was prevalent in PLWH, and it was further associated with cardiovascular risk factors, diabetes, and ageing. As PLWH age, the burden of CKD may be increased with the increase in cardiovascular-related comorbidities such as diabetes.

Monitoring chronic diseases, particularly kidney disorders, in people living with HIV (PLWH) is of paramount importance. Here, a systematic search was conducted across electronic search engine and databases like PubMed, Scopus, and Google Scholar, from date of inception until December 2023, to identify pertinent studies reporting on any association between inflammation and kidney function in PLWH. Only six clinical studies in peer-reviewed journals met the inclusion criteria, involving 1467 participants aged 37 to 51, with approximately 17% being females. The report emphasizes the potential impact of highly active antiretroviral therapy (HAART) on kidney function in PLWH, highlighting the significance of monitoring inflammation markers as indicators of kidney function, even when HAART is effective. Acknowledging study limitations, particularly the scarcity of relevant research, the findings highlight a need for more research to inform on clinical guidance to optimize HIV management, particularly regarding kidney health and HAART regimens. Although very limited studies were evaluated, the study lays an important foundation for future research to uncover the complex relationship between HAART, inflammation markers, and kidney health in PLWH.

The kidneys in people living with HIV (PLWH) are constantly exposed to highly antiretroviral therapy (HAART) which may cause renal dysfunction. Cystatin C (CystC), a biomarker of renal function, is well associated with renal impairment in various populations, however, it is underexplored in the South African population of PLWH, as compared to creatinine-based measurements. Creatinine-based measurements for assessing kidney function in people with HIV can be limited due to the influence of muscle wasting, altered creatinine metabolism, and the potential for certain antiretroviral medications to impact creatinine secretion. Therefore, the current study aimed to explore the effect of HAART on renal function among PLWH with the use of Cyst C-based measures. We conducted a cross-sectional study of 111 adults PLWH, 84 on HAART, and 27 on HAART-naïve. The cluster of differentiation 4 (CD4 +) count, plasma CystC, as well as the estimated glomerular filtration rate (eGFR) using the chronic kidney disease-epidemiology collaboration (CKD-EPI) formula, were determined. In the present study, no significant differences were observed between HAART-treated and HAART-naïve groups in terms of plasma CystC and eGFR_CystC. Participants who were on HAART for > 5 years were significantly associated with eGFR_CystC < 90 mL/min/1.73 m², as indicated by substantial odds ratio of 4.39 (confidence interval: 1.60–12.02, p = 0.004) in the unadjusted analysis and even after adjustment for age, sex and smoking status, with odds ratio of 4.10 (confidence interval: 1.41–11.86, p = 0.009). Advanced World Health Organization (WHO) clinical stage significantly associated with eGFR_CystC < 90 mL/min/1.73 m² as indicated by odds ratio of 11.73 (confidence interval: 2.27–60.75, p = 0.003) in the unadjusted analysis. Even after adjusting for confounders which included age, sex, and smoking status, the association persisted, with an odds ratio of 16.71 (confidence interval: 2.57–108.75, p = 0.003). In conclusion, CystC and eGFR_CystC levels were not different between PLWH on HAART and not on HAART but prolonged HAART use for over five years and advanced HIV disease were associated with reduced renal function in this population of PLWH on HAART, as assessed using CystC-based measures. These findings may suggest that HAART had initial beneficial effects and long-term adverse effects. The future risk of progressive eGFR decline may be increased in this HIV population on HAART due to the cumulative effect of prolonged tenofovir disoproxil fumarate (TDF) use. These findings remain important to guide future research with larger populations on the management of conditions related to renal function decline in PLWH. Highlights.

People living with the human immunodeficiency virus (PLWH) are continually subjected to challenges involving the development of non-acquired immunodeficiency syndrome (AIDS)-related comorbidities despite the effectiveness of highly active antiretroviral therapy (HAART). Exacerbated oxidative stress, which is intrinsically linked to chronic inflammation, is implicated in non-AIDS comorbidities, including the increased risk of cardiovascular disease (CVD) observed in PLWH. Here, we review evidence on the potential pathological implications of myeloperoxidase (MPO), a leukocyte-derived enzyme and a key mediator of oxidative stress and inflammation, in driving CVD-related complications in PLWH. A systematic review approach was taken to identify relevant clinical studies through searches of Cochrane Libraries, PubMed, Web of Science, ScienceDirect, and Google Scholar, up to the 30 June 2025. The summarized data appraised clinical studies (n = 14) on adults (n = 1445) with a mean age of 45 years reporting on the association between MPO and enhanced lipid peroxidation marked by elevated concentrations of oxidized low-density lipoprotein cholesterol (oxLDL-C) in PLWH. Such results were consistent with elevated inflammatory markers, including high sensitivity C-reactive protein (hsCRP), which was also linked with endothelial dysfunction. There is a lack of evidence linking the duration of HAART to MPO levels or an increased risk of CVD. However, there is room to explore whether enhanced levels of oxLDL-C, in association with sustained MPO activation, could drive CVD risk in PLWH. The present review provides essential information on the pathological relevance of MPO in endothelial dysfunction and CVD risk in PLWH.

Background/Objectives: Anaemia is a critical public health challenge in Sub-Saharan Africa (SSA), particularly among adolescents. The objective was to estimate the pooled prevalence of anaemia among adolescents in SSA and synthesise evidence on its nutritional and contextual determinants. Methods: A systematic search of databases including PubMed, CINAHL and Web of Science was conducted for studies published from January 2000 to October 2025. The methodological approach was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled prevalence estimates were computed using random-effects models, and heterogeneity was assessed using the I² statistic and Cochran’s Q test. Subgroup and meta-regression analyses were performed to explore sources of variation. Determinants were synthesised as pooled odds ratios with 95% confidence intervals. Publication bias was evaluated through funnel plot asymmetry and Egger’s regression test. Results: Forty-eight (n = 48) studies involving 76,596 adolescents met the inclusion criteria. The pooled prevalence of anaemia was 33% (95% CI: 0.28–0.39), with substantial heterogeneity across studies. Factors associated with higher odds of anaemia included low dietary diversity (OR 1.74, 95% CI: 1.10–2.74) and poor iron or micronutrient supplementation adherence or lack of supplementation (OR 1.94, 95% CI: 1.25–3.01). Infection-related exposures (OR 3.03, 95% CI: 1.99–4.61) and environmental determinants (OR 2.23, 95% CI: 1.41–3.55) were also significantly associated with anaemia. Socio-demographic factors associated with anaemia included menstrual factors among girls (OR 2.51, 95% CI: 1.58–3.99), household size (OR 3.32, 95% CI: 1.61–6.85), awareness (OR 1.71, 95% CI: 1.08–2.70), and age group (OR 2.37, 95% CI: 1.47–3.83). Conclusions: Anaemia among adolescents in SSA remains an important public health concern, although the pooled estimates should be interpreted cautiously because of substantial heterogeneity and methodological differences across studies. The findings suggest that adolescent anaemia is associated with multiple nutritional and contextual factors, but more consistent and context-specific research is needed to refine regional estimates and guide interventions.

Background: Chronic inflammation is a well-documented feature of human immunodeficiency virus (HIV) infection and is implicated in the progression of several comorbidities, including chronic kidney disease (CKD). Notably, chronic coagulation activation is another common phenomenon mediated by chronic inflammation among people living with HIV (PLWH) and has also been linked to CKD progression. However, the relationship between inflammation, coagulation and renal dysfunction remains underexplored in African populations with high HIV prevalence. This study investigated the association between systemic inflammation, coagulation activation and renal function among PLWH, particularly those receiving antiretroviral therapy (ART). Methods: In this cross-sectional study, 151 adults were enrolled, comprising 80 PLWH on ART, 27 PLWH not on ART, and 44 people not living with HIV (PNLWH). Inflammatory marker, C-reactive protein (CRP) and coagulation markers including fibrinogen and D-dimer, were measured and CKD stages were determined using estimated glomerular filtration rate (eGFR), which was calculated based on cystatin C (cystC) levels (eGFR _cystC ). Results: In the overall PLWH cohort, D-dimer was significantly associated with reduced eGFR _cystC in both crude ( p = 0.004) and adjusted analyses ( p = 0.014), indicating poorer kidney function. Fibrinogen showed a significant association with reduced eGFR _cystC only after adjusting for confounders ( p = 0.048). Among PLWH on ART, D-dimer remained independently associated with reduced eGFR _cystC , while fibrinogen showed an independent association after adjustment (β = -1.54, p = 0.031). Elevated fibrinogen levels were associated with an increased odds of CKD in the overall PLWH group (AOR = 1.12, 95% CI 1.00–1.23, p = 0.0 41), and elevated D-dimer levels were associated with increased odds of CKD among those on ART (AOR = 1.01, 95% CI 1.00–1.03, p = 0.045). Conclusion: The study reveals that both D-dimer and fibrinogen, key markers of coagulation are independently associated with renal function decline and risk of CKD in PLWH, particularly those on ART. These findings suggest that coagulation activation may be an early indicator of declining kidney function and increased risk of CKD in PLWH, potentially preceding overt systemic inflammation.