In addition, most of them did not have risk factors for renal function impairment (i.e. diabetes, hypertension), except hepatitis C. Since HIV itself is an independent factor for renal impairment, and low CD4 cell count and high VL are associated with a higher risk of end-stage renal diseases [27], recovery of CD4 cell count and viral suppression by this second-line regimen might lead to recovery of renal function. This evidence concerns the gene CD4 and chronic kidney disease.