Clinical trial NCT05685810: Genetic Determinants of Kidney Disease in People of African Ancestry With HIV
Official title: Genetic and Clinical Determinants of Cardiovascular Disease, Diabetes, Kidney Disease and Obesity in People of African Ancestry With HIV
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: HIV Nephropathy
Kidney Injury
Kidney Diseases
Diabetes Mellitus
Obesity
Cardiovascular Diseases
Genetic Predisposition to Disease
Lead sponsor: King's College Hospital NHS Trust
Sponsor class: OTHER
Collaborators: name: Guy's and St Thomas' NHS Foundation Trust
name: St George's University Hospitals NHS Foundation Trust
name: Lewisham and Greenwich NHS Trust
name: Royal Free Hospital NHS Foundation Trust
name: Central and North West London NHS Foundation Trust
name: Barts & The London NHS Trust
name: Chelsea and Westminster NHS Foundation Trust
name: Imperial College Healthcare NHS Trust
name: North Middlesex University Hospital NHS Trust
name: Brighton and Sussex University Hospitals NHS Trust
name: The Leeds Teaching Hospitals NHS Trust
name: Manchester University NHS Foundation Trust
name: Newcastle-upon-Tyne Hospitals NHS Trust
name: South Tees Hospitals NHS Foundation Trust
name: Africa Advocacy Foundation
name: Vanderbilt University
name: University of Cape Town
name: University of Pennsylvania
name: Medical Research Council
name: Guy's and St. Thomas' Charity
name: British HIV Association
name: Gilead Sciences
First posted: 2023-01-17
Enrollment: 3029
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: OTHER
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Black people with HIV infection who received care at one of 15 HIV clinics in the United Kingdom.

Brief summary: Black ethnicity is a major risk factor for chronic kidney disease \[CKD\] in people with HIV infection, suggesting that genetic factors are an important determinant of kidney disease progression in this population. The Gen-Africa study was established in 2018 to allow the study of genetic and clinical risk factors for CKD in people with HIV in the UK. Just over 3000 people across 15 sites were enrolled between May 2018 and January 2020. Demographic and clinical information was collected, and biological samples (buffy coats, plasma and urine) obtained. Cross-sectional analyses have revealed that participants of West-African ancestry are at higher risk of CKD and end-stage kidney disease \[ESKD\], and that genetic variants in the apolipoprotein L1 (APOL1) gene and sickle cell trait (SCT) are predictors of CKD and ESKD. The pathogenesis of APOL1- and SCT-associated CKD is incompletely understood, and additional, longitudinal data will be collected to improve understanding of the contribution of demographic, traditional CKD (diabetes, hypertension, obesity/metabolic syndrome, cardiovascular disease) and HIV (immuno-virological and hepatitis B/C co-infection status, antiretroviral medications) risk factors as well as additional genetic and epigenetic markers.

Detailed description: At enrolment, just over 3,000 people of (self-identified) back ethnicity provided informed consent, a blood and urine sample, weight, height, and blood pressure measurements, and completed a short questionnaire about your health issues and lifestyle factors. HIV treatment history, including most recent and nadir CD4 count and HIV viral load, viral hepatitis status and kidney function measurements were recorded. Records for about 2,350 participants have been successfully linked to the United Kingdom Collaborative HIV Cohort (UK CHIC) which has collected data (demographics, clinical and laboratory parameters) on people with HIV since 1998 at selected clinics in the United Kingdom.

Several GEN-AFRICA sub-studies (CKD-AFRICA, Coronavirus disease (CoV)-AFRICA, Ob-AFRICA) have been conducted or are being planned. Each of these studies has received, or will be submitted for, regulatory approval. The studies have allowed or will allow collection of more detailed clinical information, additional biological samples, and/or through linkage with electronic clinical records, collection of longitudinal data on HIV (CD4, HIV viral load, AIDS-defining illnesses, and details of antiretroviral therapy), comorbidities (diabetes, hypertension, kidney disease, cardiovascular events), measurements such as blood pressure and weight, and results of blood tests including measures of kidney function performed as part of clinical monitoring.

Data collected as part of the GEN-AFRICA study / sub-studies are stored at King's College Hospital under their GEN-AFRICA/CKD-AFRICA/CoV-AFRICA/Ob-AFRICA study identifiers (ID). Samples collected as part of these protocols are labeled by study ID and stored in the James Black Building, King's College London, London, UK, in compliance with human tissue act (HTA) standards. Prof. Frank post is the custodian of the data and samples and will be responsible for ensuring all study activity is compliant with relevant data protection and other policies.

Eligibility criteria: Inclusion Criteria:

* HIV positive
* Black ethnicity (self-identified)
* Informed consent

Exclusion Criteria:

* None

Primary outcomes:
measure: Kidney disease
timeFrame: 2018-2030
Secondary outcomes:
measure: Coronavirus disease (COVID-19)
timeFrame: 2020-2023
measure: Multi-morbidity
timeFrame: 2019-2023
measure: Weight change
timeFrame: 2013-2024
measure: Obesity
timeFrame: 2013-2024
measure: Dysglycaemia
timeFrame: 2019-2023
measure: Insulin resistance
timeFrame: 2019-2023
Other outcomes:
Locations:
city: London
country: United Kingdom
facility: King's College Hospital NHS Foundation Trust
Study officials:
affiliation: King's College Hospital NHS Trust
name: Frank A Post
role: PRINCIPAL_INVESTIGATOR
References:
citation: Hung RKY, Santana-Suarez B, Binns-Roemer E, Campbell L, Bramham K, Hamzah L, Fox J, Burns JE, Clarke A, Vincent R, Jones R, Price DA, Onyango D, Harber M, Hilton R, Booth JW, Sabin CA, Winkler CA, Post FA; GEN-AFRICA study group. The epidemiology of kidney disease in people of African ancestry with HIV in the UK. EClinicalMedicine. 2021 Jul 8;38:101006. doi: 10.1016/j.eclinm.2021.101006. eCollection 2021 Aug.
citation: Hung RKY, Binns-Roemer E, Booth JW, Hilton R, Harber M, Santana-Suarez B, Campbell L, Fox J, Ustianowski A, Cosgrove C, Burns JE, Clarke A, Price DA, Chadwick D, Onyango D, Hamzah L, Bramham K, Sabin CA, Winkler CA, Post FA; GEN-AFRICA Study Group. Genetic Variants of APOL1 Are Major Determinants of Kidney Failure in People of African Ancestry With HIV. Kidney Int Rep. 2022 Jan 25;7(4):786-796. doi: 10.1016/j.ekir.2022.01.1054. eCollection 2022 Apr.
citation: Hung RKY, Binns-Roemer E, Booth JW, Hilton R, Fox J, Burns F, Harber M, Ustianowski A, Hamzah L, Burns JE, Clarke A, Price DA, Kegg S, Onyango D, Santana-Suarez B, Campbell L, Bramham K, Sharpe CC, Sabin CA, Winkler CA, Post FA; GEN-AFRICA Study Group. Sickle Cell Trait and Kidney Disease in People of African Ancestry With HIV. Kidney Int Rep. 2021 Dec 13;7(3):465-473. doi: 10.1016/j.ekir.2021.12.007. eCollection 2022 Mar.
citation: Hung RKY, Rosenberg KL, David V, Binns-Roemer E, Booth JW, Hilton R, Fox J, Burns F, Ustianowski A, Cosgrove C, Hamzah L, Burns JE, Clarke A, Chadwick D, Price DA, Kegg S, Campbell L, Bramham K, Sabin CA, Post FA, Winkler CA; GEN-AFRICA Study Group. GSTM1 Copy Number and Kidney Disease in People With HIV. Kidney Int Rep. 2022 May 13;7(8):1901-1904. doi: 10.1016/j.ekir.2022.05.003. eCollection 2022 Aug. No abstract available.
citation: Hung R, Patel N, Fox J, Cosgrove C, Pett SL, Burns F, Ustianowski A, Rosenvinge M, Bhagani S, Dusheiko G, Childs K, Post FA; GEN-AFRICA study group. Prevalence of HIV/hepatitis B and HIV/hepatitis C coinfection among people of East, South, Central and West African ancestry in the United Kingdom. AIDS. 2021 Aug 1;35(10):1701-1704. doi: 10.1097/QAD.0000000000002929.
citation: Mazaheri T, Buchanan D, Hung R, Campbell L, Hamzah L, Bramham K, Vincent RP, Post FA. Creatinine and cystatin C-based estimated glomerular filtration rate estimates of kidney function in Black people with HIV on antiretroviral therapy. AIDS. 2023 Apr 1;37(5):753-758. doi: 10.1097/QAD.0000000000003466. Epub 2022 Dec 23.
citation: Cechin L, Campbell L, Oliveira A, Goff LM, Post FA. HbA1c screening for diabetes mellitus and to evaluate diabetic control in people of African ancestry with HIV in South London. Int J STD AIDS. 2023 Jun;34(7):484-487. doi: 10.1177/09564624231162163. Epub 2023 Mar 15.