Cystatin C in HIV Patients: More Than Just a GFR Marker pp. 105-120
Authors: (Amandine Gagneux-Brunon, Christophe Mariat, Pierre Delanaye, Service de Néphrologie, CHU de Saint-Etienne, Saint-Etienne, France, and others)
Abstract: With the development of highly active antiretroviral therapy (HAART), chronic kidney disease has become a relevant cause of morbidity in individuals infected by HIV. In this context, cystatin C is emerging as an interesting biomarker both for the evaluation of glomerular filtration rate (GFR) and the detection of drug-induced kidney injury.
In this chapter, we will first focus on serum cystatin C as a GFR marker in HIV infected patients. We will compare the respective advantages and limitations of serum creatinine and cystatin C in the context of HIV infection and will review the very first clinical studies on the use of cystatin C in this specific setting. Secondly, we will discuss the potential interest of urine cystatin C as a biomarker to detect renal tubular injuries associated with nucleotide
reverse transcriptase inhibitors therapies. We will conclude by examining the questions that need to be answered in order to clarify the real added value of cystatin C for the management of HIV infected patients.