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

Lucas GM, Jing Y, Sulkowski M, Abraham AG, Estrella MM, Atta MG, Fine DM, Klein MB, Silverberg MJ, Gill MJ, Moore RD, Gebo KA, Sterling TR, Butt AA, NA-ACCORD of the IeDEA
J Infect Dis. 2013 208 (8): 1240-9

PMID: 23904290 · PMCID: PMC3778973 · DOI:10.1093/infdis/jit373

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.

MeSH Terms (20)

Adult Canada Chi-Square Distribution Cohort Studies Female Glomerular Filtration Rate Hepacivirus Hepatitis C HIV Infections Humans Incidence Male Middle Aged Proportional Hazards Models Renal Insufficiency, Chronic Risk Factors RNA, Viral Substance Abuse, Intravenous United States Viremia

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