Lars Jørgen Østergaard

Hepatitis c virus viremia increases the Incidence of chronic kidney disease in HIV-infected Patients

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Lars Peters, University of Copenhagen
  • ,
  • Daniel Grint, University College London
  • ,
  • Jens D. Lundgren, University of Copenhagen
  • ,
  • Jürgen K. Rockstroh, University of Bonn
  • ,
  • Vincent Soriano, Hospital Carlos III
  • ,
  • Peter Reiss, University of Amsterdam
  • ,
  • Anna Grzeszczuk, Medical University of Bialystok
  • ,
  • Helen Sambatakou, University of Athens, Ippokration Genereal Hospital
  • ,
  • Amanda Mocroft, University College London
  • ,
  • Ole Kirk, University of Copenhagen
  • ,
  • EuroSIDA in EuroCOORD

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 1.73m2 or less for patients with a baseline eGFR more than 60 ml/min per 1.73m2 or a confirmed 25% decline in eGFR for patients with a baseline eGFR of 60 ml/min per 1.73m2 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-HCVpositive of whom 983 (47.9%) were HCV-RNA-positive, 193 (9.4%) HCV-RNAnegative 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 1.73m2. During 36123 personyears 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.

Original languageEnglish
JournalAIDS
Volume26
Issue15
Pages (from-to)1917-1926
Number of pages10
ISSN0269-9370
DOIs
Publication statusPublished - 24 Sep 2012

    Research areas

  • coinfection, hepatitis C virus, HIV, kidney disease, viremia

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