Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults.
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...
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2012-01-01
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doaj-1f1049b4c5c9470f8ada5a4b5c39ea6b2020-11-25T01:57:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0177e4024510.1371/journal.pone.0040245Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults.Amanda MocroftJacqueline NeuhausLars PetersLene RyomMarkus BickelDaniel GrintJanak KoiralaAleksandra SzymczakJens LundgrenMichael J RossChristina M WyattINSIGHT SMART Study GroupESPRIT Study GroupChronic 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.ClinicalTrials.gov NCT00027352; NCT00004978.http://europepmc.org/articles/PMC3401192?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amanda Mocroft Jacqueline Neuhaus Lars Peters Lene Ryom Markus Bickel Daniel Grint Janak Koirala Aleksandra Szymczak Jens Lundgren Michael J Ross Christina M Wyatt INSIGHT SMART Study Group ESPRIT Study Group |
spellingShingle |
Amanda Mocroft Jacqueline Neuhaus Lars Peters Lene Ryom Markus Bickel Daniel Grint Janak Koirala Aleksandra Szymczak Jens Lundgren Michael J Ross Christina M Wyatt INSIGHT SMART Study Group ESPRIT Study Group Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. PLoS ONE |
author_facet |
Amanda Mocroft Jacqueline Neuhaus Lars Peters Lene Ryom Markus Bickel Daniel Grint Janak Koirala Aleksandra Szymczak Jens Lundgren Michael J Ross Christina M Wyatt INSIGHT SMART Study Group ESPRIT Study Group |
author_sort |
Amanda Mocroft |
title |
Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. |
title_short |
Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. |
title_full |
Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. |
title_fullStr |
Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. |
title_full_unstemmed |
Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. |
title_sort |
hepatitis b and c co-infection are independent predictors of progressive kidney disease in hiv-positive, antiretroviral-treated adults. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2012-01-01 |
description |
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.ClinicalTrials.gov NCT00027352; NCT00004978. |
url |
http://europepmc.org/articles/PMC3401192?pdf=render |
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