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J Infect Dis. 2013 Oct 15;208(8):1240-9. doi: 10.1093/infdis/jit373. Epub 2013 Jul 31.

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

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1
Johns Hopkins University, Baltimore, Maryland.

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.

KEYWORDS:

HIV; chronic kidney disease; cohort study; glomerular filtration rate; hepatitis C RNA; hepatitis C virus; injection drug use

PMID:
23904290
PMCID:
PMC3778973
DOI:
10.1093/infdis/jit373
[Indexed for MEDLINE]
Free PMC Article

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