Hepatitis C co-infection is associated with an increased risk of incident chronic kidney disease in HIV-infected patients initiating combination antiretroviral therapy

BMC Infectious Diseases

Research Article

Jason Chia¹  Robert S. Hogg²  Mark Hull³  Janet Raboud⁴  Erica E.M. Moodie⁵  Carmine Rossi⁶  Marina B. Klein⁷  Ann N. Burchell⁸  Tony Antoniou⁸  Curtis Cooper⁹  Sharon Walmsley^1,10 

[1] BC Centre for Excellence in HIV/AIDS, Vancouver, Canada;BC Centre for Excellence in HIV/AIDS, Vancouver, Canada;Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada;BC Centre for Excellence in HIV/AIDS, Vancouver, Canada;Faculty of Medicine, University of British Columbia, Vancouver, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;Toronto General Hospital Research Institute, University Health Network, Toronto, Canada;Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Canada;Research Institute of the McGill University Health Centre, Montréal, Canada;Research Institute of the McGill University Health Centre, Montréal, Canada;Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, 1001 Decarie Boulevard, D02.4110, H4A 3J1, Montréal, Canada;St. Michael’s Hospital, University of Toronto, Toronto, Canada;The Ottawa Hospital, General Campus, Ottawa, Canada;Toronto General Hospital Research Institute, University Health Network, Toronto, Canada;

关键词: Antiretroviral therapy;    Chronic kidney disease;    Co-infection;    Glomerular filtration;    Hepatitis C;    HIV;   

DOI  :  10.1186/s12879-017-2350-8

 received in 2016-12-13, accepted in 2017-03-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCombination antiretroviral therapy (cART) has reduced mortality from AIDS-related illnesses and chronic comorbidities have become prevalent among HIV-infected patients. We examined the association between hepatitis C virus (HCV) co-infection and chronic kidney disease (CKD) among patients initiating modern antiretroviral therapy.MethodsData were obtained from the Canadian HIV Observational Cohort for individuals initiating cART from 2000 to 2012. Incident CKD was defined as two consecutive serum creatinine-based estimated glomerular filtration (eGFR) measurements <60 mL/min/1.73m2 obtained ≥3 months apart. CKD incidence rates after cART initiation were compared between HCV co-infected and HIV mono-infected patients. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression.ResultsWe included 2595 HIV-infected patients with eGFR >60 mL/min/1.73m2 at cART initiation, of which 19% were HCV co-infected. One hundred and fifty patients developed CKD during 10,903 person-years of follow-up (PYFU). The CKD incidence rate was higher among co-infected than HIV mono-infected patients (26.0 per 1000 PYFU vs. 10.7 per 1000 PYFU). After adjusting for demographics, virologic parameters and traditional CKD risk factors, HCV co-infection was associated with a significantly shorter time to incident CKD (HR 1.97; 95% CI: 1.33, 2.90). Additional factors associated with incident CKD were female sex, increasing age after 40 years, lower baseline eGFR below 100 mL/min/1.73m2, increasing HIV viral load and cumulative exposure to tenofovir and lopinavir.ConclusionsHCV co-infection was associated with an increased risk of incident CKD among HIV-infected patients initiating cART. HCV-HIV co-infected patients should be monitored for kidney disease and may benefit from available HCV treatments.

【 授权许可】

CC BY   
© The Author(s). 2017