Abstract / Summary
Abstract Background Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), remains a significant global health challenge. People living with HIV (PLHIV) may face an elevated risk of severe complications, particularly those with low CD4 counts, high viral loads, advanced clinical disease, or antiretroviral therapy (ART) non-adherence. Lockdown-related ART disruptions further compounded these risks. This study aimed to evaluate the prevalence of chronic kidney disease (CKD) among HIV patients co-infected with COVID-19. Methods This hospital-based cross-sectional study included 423 adults aged ≥ 18 years attending UITH HIV clinic from May to October, 2022. Exclusion criteria included incomplete records and sickle cell anaemia. SARS-CoV-2 status was determined via polymerase chain reaction (PCR). CKD was defined as eGFR < 60 mL/min/1.73 m² (using the CKD-EPI equation without race coefficient for African population) via Jaffe’s method. Proteinuria ≥ + 1 measured via dipstick urinalysis were considered a significant indicator of renal dysfunction. Data were analysed using SPSS version 21 to identify independent predictors of COVID-19 and CKD. Results The prevalence of COVID-19 infection was 13.5% ( n = 53). Among HIV/SARS-CoV-2 co-infected, 73.5% ( n = 39) were asymptomatic and 56.6% ( n = 30) had been vaccinated with SARS-CoV-2 vaccine. Hypertension was independently associated with testing positive for COVID-19 (adjusted odds ratio (AOR) = 4.11, 95% CI: 1.48–11.42, p = 0.007). The overall prevalence of CKD was 8.4%. Independent predictors of CKD were advancing age (AOR = 1.09 per year, 95% CI = 1.04–1.13, p < 0.001), positive proteinuria (AOR = 4.67, 95% CI: 2.06–10.60, p < 0.001), and ART duration of < 1 year relative to > 5 years (AOR = 3.87, 95% CI: 1.20–12.49, p = 0.023). Among HIV/SARS-CoV-2 co-infected participants, CKD prevalence was 1.5%. Conclusions We did not find an association between COVID-19 and CKD burden among PLHIV, but were limited by small number. Identified CKD risk factors were ageing, ART duration, and positive proteinuria-a critical baseline marker. Furthermore, the link between hypertension and COVID-19 highlights the importance of targeted cardiovascular and renal monitoring within routine HIV care.