Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults.

Published

Journal Article

UNLABELLED: Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-positive individuals. Hepatitis C (HCV) co-infection has been associated with increased risk of CKD, but prior studies lack information on potential mechanisms. We evaluated the association between HCV or hepatitis B (HBV) co-infection and progressive CKD among 3,441 antiretroviral-treated clinical trial participants. Progressive CKD was defined as the composite of end-stage renal disease, renal death, or significant glomerular filtration rate (eGFR) decline (25% decline to eGFR <60 mL/min/1.73 m(2) or 25% decline with a baseline <60). Generalized Estimating Equations were used to model the odds of progressive CKD. At baseline, 13.8% and 3.3% of participants were co-infected with HCV and HBV, respectively. Median eGFR was 111, and 3.7% developed progressive CKD. After adjustment, the odds of progressive CKD were increased in participants with HCV (OR 1.72, 95% CI 1.07-2.76) or HBV (OR 2.26, 95% CI 1.15-4.44). Participants with undetectable or low HCV-RNA had similar odds of progressive CKD as HCV seronegative participants, while participants with HCV-RNA >800,000 IU/ml had increased odds (OR 3.07; 95% CI 1.60-5.90). Interleukin-6, hyaluronic acid, and the FIB-4 hepatic fibrosis index were higher among participants who developed progressive CKD, but were no longer associated with progressive CKD after adjustment. Future studies should validate the relationship between HCV viremia and CKD. TRIAL REGISTRATION: ClinicalTrials.gov NCT00027352; NCT00004978.

Full Text

Duke Authors

Cited Authors

  • Mocroft, A; Neuhaus, J; Peters, L; Ryom, L; Bickel, M; Grint, D; Koirala, J; Szymczak, A; Lundgren, J; Ross, MJ; Wyatt, CM; INSIGHT SMART Study Group, ; ESPRIT Study Group,

Published Date

  • 2012

Published In

Volume / Issue

  • 7 / 7

Start / End Page

  • e40245 -

PubMed ID

  • 22911697

Pubmed Central ID

  • 22911697

Electronic International Standard Serial Number (EISSN)

  • 1932-6203

Digital Object Identifier (DOI)

  • 10.1371/journal.pone.0040245

Language

  • eng

Conference Location

  • United States