Hepatitis C virus viremia increases the incidence of chronic kidney disease in HIV-infected patients
Lars Peters, Daniel Grint, Jens D Lundgren, Jürgen K Rockstroh, Vincent Soriano, Peter Reiss, Anna Grzeszczuk, Helen Sambatakou, Amanda Mocroft, Ole Kirk, EuroSIDA in EuroCoord, M Losso, C Elias, J M Ramos, N Vetter, Zentrum der Stadt Wien, R Zangerle, I Karpov, A Vassilenko, V M Mitsura, O Suetnov, N Clumeck, S De Wit, M Delforge, L Vandekerckhove, V Hadziosmanovic, K Kostov, J Begovac, L Machala, D Jilich, D Sedlacek, G Kronborg, T Benfield, M Larsen, J Gerstoft, T Katzenstein, A -B E Hansen, P Skinhøj, C Pedersen, L Ostergaard, K Zilmer, J Smidt, Nakkusosakond Siseklinik, C Katlama, Edouard Herriot, P Vanhems, Claude Bernard, C Pradier, F Dabis, D Neau, R Schmidt, J van Lunzen, O Degen, S Staszewski, J W Goethe, J Bogner, P Gargalianos, G Xylomenos, J Perdios, G Panos, A Filandras, E Karabatsaki, H Sambatakou, D Banhegyi, F Mulcahy, D Turner, M Burke, S Pollack, G Hassoun, S Maayan, S Vella, R Esposito, I Mazeu, C Mussini, C Arici, R Pristera, F Mazzotta, A Gabbuti, S Maria, V Vullo, M Lichtner, A Chirianni, E Montesarchio, M Gargiulo, A D Cotugno, G Antonucci, A Testa, P Narciso, C Vlassi, M Zaccarelli, Lazzaro Spallanzani, A Lazzarin, A Castagna, N Gianotti, M Galli, A Ridolfo, L Sacco, A d'Arminio Monforte, Malattie Infettive, B Rozentale, I Zeltina, S Chaplinskas, R Hemmer, T Staub, P Reiss, V Ormaasen, A Maeland, J Bruun, J Gasiorowski, A Horban, E Bakowska, A Grzeszczuk, R Flisiak, A Boron-Kaczmarska, M Pynka, M Parczewski, M Beniowski, E Mularska, Osrodek Diagnostyki, H Trocha, E Jablonowska, E Malolepsza, K Wojcik, F Antunes, M Doroana, L Caldeira, K Mansinho, F Maltez, D Duiculescu, A Rakhmanova, N Zakharova, S Buzunova, D Jevtovic, M Mokrás, J Tomazic, J González-Lahoz, V Soriano, P Labarga, J Medrano, S Moreno, J M Rodriguez, B Clotet, A Jou, R Paredes, C Tural, J Puig, I Bravo, J M Gatell, J M Miró, P Domingo, M Gutierrez, G Mateo, M A Sambeat, A Karlsson, L Flamholc, R Weber, P Francioli, M Cavassini, B Hirschel, E Boffi, H Furrer, M Battegay, L Elzi, E Kravchenko, N Chentsova, V Frolov, G Kutsyna, S Servitskiy, M Krasnov, S Barton, A M Johnson, D Mercey, A Phillips, M A Johnson, A Mocroft, M Murphy, J Weber, G Scullard, M Fisher, C Leen, Lars Peters, Daniel Grint, Jens D Lundgren, Jürgen K Rockstroh, Vincent Soriano, Peter Reiss, Anna Grzeszczuk, Helen Sambatakou, Amanda Mocroft, Ole Kirk, EuroSIDA in EuroCoord, M Losso, C Elias, J M Ramos, N Vetter, Zentrum der Stadt Wien, R Zangerle, I Karpov, A Vassilenko, V M Mitsura, O Suetnov, N Clumeck, S De Wit, M Delforge, L Vandekerckhove, V Hadziosmanovic, K Kostov, J Begovac, L Machala, D Jilich, D Sedlacek, G Kronborg, T Benfield, M Larsen, J Gerstoft, T Katzenstein, A -B E Hansen, P Skinhøj, C Pedersen, L Ostergaard, K Zilmer, J Smidt, Nakkusosakond Siseklinik, C Katlama, Edouard Herriot, P Vanhems, Claude Bernard, C Pradier, F Dabis, D Neau, R Schmidt, J van Lunzen, O Degen, S Staszewski, J W Goethe, J Bogner, P Gargalianos, G Xylomenos, J Perdios, G Panos, A Filandras, E Karabatsaki, H Sambatakou, D Banhegyi, F Mulcahy, D Turner, M Burke, S Pollack, G Hassoun, S Maayan, S Vella, R Esposito, I Mazeu, C Mussini, C Arici, R Pristera, F Mazzotta, A Gabbuti, S Maria, V Vullo, M Lichtner, A Chirianni, E Montesarchio, M Gargiulo, A D Cotugno, G Antonucci, A Testa, P Narciso, C Vlassi, M Zaccarelli, Lazzaro Spallanzani, A Lazzarin, A Castagna, N Gianotti, M Galli, A Ridolfo, L Sacco, A d'Arminio Monforte, Malattie Infettive, B Rozentale, I Zeltina, S Chaplinskas, R Hemmer, T Staub, P Reiss, V Ormaasen, A Maeland, J Bruun, J Gasiorowski, A Horban, E Bakowska, A Grzeszczuk, R Flisiak, A Boron-Kaczmarska, M Pynka, M Parczewski, M Beniowski, E Mularska, Osrodek Diagnostyki, H Trocha, E Jablonowska, E Malolepsza, K Wojcik, F Antunes, M Doroana, L Caldeira, K Mansinho, F Maltez, D Duiculescu, A Rakhmanova, N Zakharova, S Buzunova, D Jevtovic, M Mokrás, J Tomazic, J González-Lahoz, V Soriano, P Labarga, J Medrano, S Moreno, J M Rodriguez, B Clotet, A Jou, R Paredes, C Tural, J Puig, I Bravo, J M Gatell, J M Miró, P Domingo, M Gutierrez, G Mateo, M A Sambeat, A Karlsson, L Flamholc, R Weber, P Francioli, M Cavassini, B Hirschel, E Boffi, H Furrer, M Battegay, L Elzi, E Kravchenko, N Chentsova, V Frolov, G Kutsyna, S Servitskiy, M Krasnov, S Barton, A M Johnson, D Mercey, A Phillips, M A Johnson, A Mocroft, M Murphy, J Weber, G Scullard, M Fisher, C Leen
Abstract
Background: Several studies have reported on an association between hepatitis C virus (HCV) antibody status and the development of chronic kidney disease (CKD), but the role of HCV viremia and genotype are not well defined.
Methods: Patients with at least three serum creatinine measurements after 1 January 2004 and known HCV antibody status were included. Baseline was defined as the first eligible estimated glomerular filtration rate (eGFR) (Cockcroft-Gault equation), and CKD was either a confirmed (>3 months apart) eGFR of 60 ml/min per 1.73 m or less for patients with a baseline eGFR more than 60 ml/min per 1.73 m or a confirmed 25% decline in eGFR for patients with a baseline eGFR of 60 ml/min per 1.73 m or less. Incidence rates of CKD were compared between HCV groups (anti-HCV-negative, anti-HCV-positive with or without viremia) using Poisson regression.
Results: Of 8235 patients with known anti-HCV status, 2052 (24.9%) were anti-HCV-positive of whom 983 (47.9%) were HCV-RNA-positive, 193 (9.4%) HCV-RNA-negative and 876 (42.7%) had unknown HCV-RNA. At baseline, the median eGFR was 97.6 (interquartile range 83.8-113.0) ml/min per 1.73 m. During 36123 person-years of follow-up (PYFU), 495 patients progressed to CKD (6.0%) with an incidence rate of 14.5 per 1000 PYFU (95% confidence interval 12.5-14.9). In a multivariate Poisson model, patients who were anti-HCV-positive with HCV viremia had a higher incidence rate of CKD, whereas patients with cleared HCV infection had a similar incidence rate of CKD compared with anti-HCV-negative patients. There was no association between CKD and HCV genotype.
Conclusion: Compared with HIV-monoinfected patients, HIV-positive patients with chronic rather than cleared HCV infection were at increased risk of developing CKD, suggesting a contribution from active HCV infection toward the pathogenesis of CKD.
Source: PubMed