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Highly active antiretroviral therapy and the epidemic of HIV+ end-stage renal disease.

Publication ,  Journal Article
Schwartz, EJ; Szczech, LA; Ross, MJ; Klotman, ME; Winston, JA; Klotman, PE
Published in: J Am Soc Nephrol
August 2005

The rise in the number of patients with HIV-associated nephropathy and HIV-infection with end-stage renal disease (HIV+ ESRD) continues to be a substantial concern for the ESRD program. In order to assess the impact of highly active antiretroviral therapy (HAART) on the progression of patients with AIDS to the development of ESRD and to project the prevalence of HIV+ ESRD through 2020, a mathematical model of the dynamics of HIV+ infection in the ESRD population was developed. Epidemiologic data on AIDS and HIV+ ESRD among black individuals in the United States were obtained since 1991 from the Centers for Disease Control and Prevention and US Renal Data System, respectively. The model was constructed to predict the prevalence of HIV+ ESRD incorporating the current rate of growth in AIDS prevalence. Two possible trends were considered: linear AIDS growth and exponential AIDS growth. The likely effectiveness of HAART in slowing progression to HIV+ ESRD was estimated from the best fit of the model to the data after 1995, when HAART was introduced. The model was then used to evaluate recent data and to project the prevalence of HIV+ ESRD through 2020. The model suggested that HAART has reduced the rate of progression from AIDS to HIV+ ESRD by 38%. The model projected an increase in HIV+ ESRD prevalence in the future as a result of the increase in the AIDS population among black individuals. This increase was predicted even assuming a 95% reduction in the progression from AIDS to HIV+ ESRD. Despite the potential benefit of HAART, the prevalence of HIV+ ESRD in the United States is expected to rise in the future as a result of the expansion of the AIDS population among black individuals. It is concluded that prevention of progression to ESRD should focus on early antiretroviral treatment of HIV-infected patients who have evidence of HIV-associated nephropathy.

Duke Scholars

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Published In

J Am Soc Nephrol

DOI

ISSN

1046-6673

Publication Date

August 2005

Volume

16

Issue

8

Start / End Page

2412 / 2420

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Time Factors
  • Prevalence
  • Models, Theoretical
  • Least-Squares Analysis
  • Kidney Failure, Chronic
  • Humans
  • HIV Infections
  • Forecasting
 

Citation

APA
Chicago
ICMJE
MLA
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Schwartz, E. J., Szczech, L. A., Ross, M. J., Klotman, M. E., Winston, J. A., & Klotman, P. E. (2005). Highly active antiretroviral therapy and the epidemic of HIV+ end-stage renal disease. J Am Soc Nephrol, 16(8), 2412–2420. https://doi.org/10.1681/ASN.2005040340
Schwartz, Elissa J., Lynda A. Szczech, Michael J. Ross, Mary E. Klotman, Jonathan A. Winston, and Paul E. Klotman. “Highly active antiretroviral therapy and the epidemic of HIV+ end-stage renal disease.J Am Soc Nephrol 16, no. 8 (August 2005): 2412–20. https://doi.org/10.1681/ASN.2005040340.
Schwartz EJ, Szczech LA, Ross MJ, Klotman ME, Winston JA, Klotman PE. Highly active antiretroviral therapy and the epidemic of HIV+ end-stage renal disease. J Am Soc Nephrol. 2005 Aug;16(8):2412–20.
Schwartz, Elissa J., et al. “Highly active antiretroviral therapy and the epidemic of HIV+ end-stage renal disease.J Am Soc Nephrol, vol. 16, no. 8, Aug. 2005, pp. 2412–20. Pubmed, doi:10.1681/ASN.2005040340.
Schwartz EJ, Szczech LA, Ross MJ, Klotman ME, Winston JA, Klotman PE. Highly active antiretroviral therapy and the epidemic of HIV+ end-stage renal disease. J Am Soc Nephrol. 2005 Aug;16(8):2412–2420.

Published In

J Am Soc Nephrol

DOI

ISSN

1046-6673

Publication Date

August 2005

Volume

16

Issue

8

Start / End Page

2412 / 2420

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Time Factors
  • Prevalence
  • Models, Theoretical
  • Least-Squares Analysis
  • Kidney Failure, Chronic
  • Humans
  • HIV Infections
  • Forecasting