Hepatitis C viremia and the risk of chronic kidney disease in HIV-infected individuals.

Academic Article

Abstract

  • BACKGROUND:  The role of active hepatitis C virus (HCV) replication in chronic kidney disease (CKD) risk has not been clarified. METHODS:  We compared CKD incidence in a large cohort of HIV-infected subjects who were HCV seronegative, HCV viremic (detectable HCV RNA), or HCV aviremic (HCV seropositive, undetectable HCV RNA). Stages 3 and 5 CKD were defined according to standard criteria. Progressive CKD was defined as a sustained 25% glomerular filtration rate (GFR) decrease from baseline to a GFR < 60 mL/min/1.73 m2. We used Cox models to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS:  A total of 52 602 HCV seronegative, 9508 HCV viremic, and 913 HCV aviremic subjects were included. Compared with HCV seronegative subjects, HCV viremic subjects were at increased risk for stage 3 CKD (adjusted HR 1.36 [95% CI, 1.26, 1.46]), stage 5 CKD (1.95 [1.64, 2.31]), and progressive CKD (1.31 [1.19, 1.44]), while HCV aviremic subjects were also at increased risk for stage 3 CKD (1.19 [0.98, 1.45]), stage 5 CKD (1.69 [1.07, 2.65]), and progressive CKD (1.31 [1.02, 1.68]). CONCLUSIONS:  Compared with HIV-infected subjects who were HCV seronegative, both HCV viremic and HCV aviremic individuals were at increased risk for moderate and advanced CKD.
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    Keywords

  • HIV, chronic kidney disease, cohort study, glomerular filtration rate, hepatitis C RNA, hepatitis C virus, injection drug use, Adult, Canada, Chi-Square Distribution, Cohort Studies, Female, Glomerular Filtration Rate, HIV Infections, Hepacivirus, Hepatitis C, Humans, Incidence, Male, Middle Aged, Proportional Hazards Models, RNA, Viral, Renal Insufficiency, Chronic, Risk Factors, Substance Abuse, Intravenous, United States, Viremia
  • Digital Object Identifier (doi)

    Author List

  • Lucas GM; Jing Y; Sulkowski M; Abraham AG; Estrella MM; Atta MG; Fine DM; Klein MB; Silverberg MJ; Gill MJ
  • Start Page

  • 1240
  • End Page

  • 1249
  • Volume

  • 208
  • Issue

  • 8