Nephrotoxicity Associated with HAART

The introduction of highly active antiretroviral therapy (HAART) in 1990s radically changed the course and management of HIV infection. Although there have been substantial reductions in morbidity and mortality of HIV- virus Infected patients, the antiretroviral medications have been associated with various toxicities, including those affecting the kidney. The prevalence of acute and chronic kidney disease has been increasing among HIV-infected patients in the United States and kidney disease has emerged as a key predictor of mortality [1-3]. The toxicities associated with the long term use of this treatment have now become a major issue and researchers have focused on understanding the cellular mechanisms underlying these drug-induced adverse effects [4]. Nephrotoxicity from antiretroviral drugs may manifest as tubular necrosis, kidney stones, acute and chronic kidney diseases. The objective of this article is to review the potential adverse effects of HAART on the kidney, with emphasis on specific antiretroviral agents that have been associated with direct kidney injury and associated metabolic disorders. Kidney injury caused by HAART is typically reversible with early detection and discontinuation of the offending agent. Nephrologists should be aware of the potential toxicity of these agents to avoid delays in diagnosis and treatment [5].

Keywords: Chronic kidney disease, diabetes mellitus, highly active antiretroviral therapy (HAART), HIV infection, hyperlipidemia, lactic acidosis, lipodystrophy syndrome, nephrolithiasis, nephrotoxicity, renal insufficiency, tubulopathies.