Abstract / Summary
People living with HIV (PLHIV) are at increased risk of liver and kidney dysfunction due to chronic HIV infection, long-term antiretroviral therapy (ART), and persistent immune activation. However, age-related differences in organ function and treatment outcomes remain insufficiently characterized in African settings. This study aimed to assess age-related differences in liver and renal function among PLHIV in Ghana to identify patterns of organ dysfunction across different age groups. This multicenter cross-sectional study included 558 PLHIV aged 10-76 years receiving ART, of whom 96.4% were on dolutegravir-based regimens. Renal function was assessed using serum urea, creatinine, urea-to-creatinine ratio, and estimated glomerular filtration rate (eGFR). Liver function was assessed using AST/ALT ratios, hepatotoxicity grading, and fibrosis indices (APRI, FIB-4), while virologic outcomes were assessed using HIV viral load measurements. A composite renal-hepatic-virologic abnormality score was developed based on reduced kidney function (eGFR < 60 mL/min/1.73 m2), elevated AST/ALT ratio (> 1), and unsuppressed viral load (≥ 1000 copies/mL). Data were analyzed using STATA, with p < 0.05 considered statistically significant. Renal, hepatic, and virologic parameters showed significant variation across age groups. Older participants, particularly those aged ≥ 60 years, had lower mean eGFR values (60.32 ± 17.17 mL/min/1.73 m2; p < 0.001), while adolescents aged 13-19 years had the highest frequency of virological failure (22.22%; p < 0.001). The composite renal-hepatic-virologic abnormality score differed significantly across age groups (p < 0.001), with adolescents aged 13-19 years having higher odds of a greater abnormality score compared with children aged ≤ 12 years (aOR = 3.15, 95% CI: 1.23-8.08; p = 0.017). In conclusion, age-related differences were observed in renal, hepatic, and virologic abnormalities among PLHIV in Ghana. These findings support the need for age-tailored biochemical monitoring and further longitudinal studies to clarify temporal relationships between aging and organ function in PLHIV.