Hepatitis C viremia and the risk of chronic kidney disease in HIV-infected individuals

J Infect Dis. 2013 Oct 15;208(8):1240-9. doi: 10.1093/infdis/jit373. Epub 2013 Jul 31.

Abstract

Background: The role of active hepatitis C virus (HCV) replication in chronic kidney disease (CKD) risk has not been clarified.

Methods: We compared CKD incidence in a large cohort of HIV-infected subjects who were HCV seronegative, HCV viremic (detectable HCV RNA), or HCV aviremic (HCV seropositive, undetectable HCV RNA). Stages 3 and 5 CKD were defined according to standard criteria. Progressive CKD was defined as a sustained 25% glomerular filtration rate (GFR) decrease from baseline to a GFR < 60 mL/min/1.73 m2. We used Cox models to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: A total of 52 602 HCV seronegative, 9508 HCV viremic, and 913 HCV aviremic subjects were included. Compared with HCV seronegative subjects, HCV viremic subjects were at increased risk for stage 3 CKD (adjusted HR 1.36 [95% CI, 1.26, 1.46]), stage 5 CKD (1.95 [1.64, 2.31]), and progressive CKD (1.31 [1.19, 1.44]), while HCV aviremic subjects were also at increased risk for stage 3 CKD (1.19 [0.98, 1.45]), stage 5 CKD (1.69 [1.07, 2.65]), and progressive CKD (1.31 [1.02, 1.68]).

Conclusions: Compared with HIV-infected subjects who were HCV seronegative, both HCV viremic and HCV aviremic individuals were at increased risk for moderate and advanced CKD.

Keywords: HIV; chronic kidney disease; cohort study; glomerular filtration rate; hepatitis C RNA; hepatitis C virus; injection drug use.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Canada / epidemiology
  • Chi-Square Distribution
  • Cohort Studies
  • Female
  • Glomerular Filtration Rate
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • HIV Infections / virology
  • Hepacivirus / isolation & purification
  • Hepatitis C / blood
  • Hepatitis C / complications
  • Hepatitis C / epidemiology*
  • Hepatitis C / virology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • RNA, Viral / blood
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / virology
  • Risk Factors
  • Substance Abuse, Intravenous / epidemiology
  • Substance Abuse, Intravenous / virology
  • United States / epidemiology
  • Viremia / complications
  • Viremia / epidemiology
  • Viremia / virology

Substances

  • RNA, Viral

Grant support