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Lucas GM. J Infect Dis. 2013;doi:10.1093/infdis/jit373.
August 8, 2013
Among people with HIV, those who were viremic and aviremic for hepatitis C were at increased risk for chronic kidney disease, compared with patients who were seronegative for the virus, researchers from Johns Hopkins University have found.
“Approximately 20% of individuals who are infected with HCV clear the viremia, although the rate of HCV clearance is lower in HIV-infected persons,” the researchers wrote in the Journal of Infectious Diseases. “To explore the contribution of persistent HCV viremia on CKD risk, we compared CKD incidence in a large cohort of HIV-infected subjects in North America according to HCV exposure status.”
The study included 52,602 HCV seronegative individuals, 9,508 individuals with detectable HCV viremia (viremic) and 913 individuals who were HCV seropositive with undetectable viremia (aviremic). All were part of the North American AIDS Cohort Collaboration on Research and Design.
HCV viremic individuals were at increased risk for stage 3 CKD (adjusted HR=1.36; 95% CI, 1.26-1.46) stage 5 CKD (aHR=1.95; 95% CI, 1.64-2.31) and progressive CKD (aHR=1.31; 95% CI 1.19-1.44) compared with HCV seronegative individuals. HCV aviremic individuals also were at increased risk for stage 3 CKD (aHR=1.19; 95% CI, 0.98-1.45), stage 5 CKD (aHR=1.69; 95% CI, 1.07=2.65) and progressive CKD (aHR=1.31; 95% CI, 1.02-1.68). The risk was similar for both HCV viremic and aviremic individuals.
“The mechanism behind increased CKD risk in HCV aviremic subjects is unclear, but may include confounding effects from drug use, poorer control of HIV infection, lower socioeconomic status, or other unidentified factors,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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