Abstract
Background. Human immunodeficiency virus (HIV)-infected adults, particularly those of black race, are at high-risk for end-stage renal disease (ESRD), but contributing factors are evolving. We hypothesized that improvements in HIV treatment have led to declines in risk of ESRD, particularly among HIV-infected blacks. Methods. Using data from the North American AIDS Cohort Collaboration for Research and Design from January 2000 to December 2009, we validated 286 incident ESRD cases using abstracted medical evidence of dialysis (lasting >6 months) or renal transplant. A total of 38 354 HIV-infected adults aged 18-80 years contributed 159 825 person-years (PYs). Age- and sex-standardized incidence ratios (SIRs) were estimated by race. Poisson regression was used to identify predictors of ESRD. Results. HIV-infected ESRD cases were more likely to be of black race, have diabetes mellitus or hypertension, inject drugs, and/or have a prior AIDS-defining illness. The overall SIR was 3.2 (95% confidence interval [CI], 2.8- 3.6) but was significantly higher among black patients (4.5 [95% CI, 3.9-5.2]). ESRD incidence declined from 532 to 303 per 100 000 PYs and 138 to 34 per 100 000 PYs over the time period for blacks and nonblacks, respectively, coincident with notable increases in both the prevalence of viral suppression and the prevalence of ESRD risk factors including diabetes mellitus, hypertension, and hepatitis C virus coinfection. Conclusions. The risk of ESRD remains high among HIV-infected individuals in care but is declining with improvements in virologic suppression. HIV-infected black persons continue to comprise the majority of cases, as a result of higher viral loads, comorbidities, and genetic susceptibility.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 941-949 |
| Number of pages | 9 |
| Journal | Clinical Infectious Diseases |
| Volume | 60 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2015 |
| Externally published | Yes |
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Keywords
- Chronic kidney disease (CKD)
- End-stage renal disease (ESRD)
- Glomerular filtration rate (GFR)
- HIV infection/AIDS
- HIV/AIDS
ASJC Scopus subject areas
- Infectious Diseases
- Microbiology (medical)
Cite this
End-stage renal disease among HIV-infected adults in North America. / Abraham, Alison G.; Althoff, Keri N.; Jing, Yuezhou; Estrella, Michelle M.; Kitahata, Mari M.; Wester, C. William; Bosch, Ronald J.; Crane, Heidi; Eron, Joseph; Gill, M. John; Horberg, Michael A.; Justice, Amy C.; Klein, Marina; Mayor, Angel M.; Moore, Richard D.; Palella, Frank J.; Parikh, Chirag R.; Silverberg, Michael J.; Golub, Elizabeth T.; Jacobson, Lisa P.; Napravnik, Sonia; Lucas, Gregory M.; Kirk, Gregory D.; Benson, Constance A.; Collier, Ann C.; Boswell, Stephen; Grasso, Chris; Mayer, Ken; Hogg, Robert S.; Harrigan, Richard; Montaner, Julio; Cescon, Angela; Brooks, John T.; Buchacz, Kate; Gebo, Kelly A.; Rodriguez, Benigno; Thorne, Jennifer E.; Goedert, James J.; Klein, Marina B.; Rourke, Sean B.; Burchell, Ann; Rachlis, Anita R.; Hunter-Mellado, Robert F.; Deeks, Steven G.; Martin, Jeffrey N.; Saag, Michael S.; Mugavero, Michael J.; Willig, James; Eron, Joseph J.; Crane, Heidi M.; Dubrow, Robert; Fiellin, David; Sterling, Timothy R.; Haas, David; Anastos, Kathryn; Turner, Megan; Gange, Stephen J.; Anastos, Kathryn; McKaig, Rosemary G.; Freeman, Aimee M.; Lent, Carol; Van Rompaey, Stephen E.; Webster, Eric; Morton, Liz; Simon, Brenda; Hanna, David B.; Zhang, Jinbing; Jing, Jerry; Modur, Shari; Hanna, David B.; Rebeiro, Peter; Wong, Cherise; Mendes, Adell.
In: Clinical Infectious Diseases, Vol. 60, No. 6, 2015, p. 941-949.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - End-stage renal disease among HIV-infected adults in North America
AU - Abraham, Alison G.
AU - Althoff, Keri N.
AU - Jing, Yuezhou
AU - Estrella, Michelle M.
AU - Kitahata, Mari M.
AU - Wester, C. William
AU - Bosch, Ronald J.
AU - Crane, Heidi
AU - Eron, Joseph
AU - Gill, M. John
AU - Horberg, Michael A.
AU - Justice, Amy C.
AU - Klein, Marina
AU - Mayor, Angel M.
AU - Moore, Richard D.
AU - Palella, Frank J.
AU - Parikh, Chirag R.
AU - Silverberg, Michael J.
AU - Golub, Elizabeth T.
AU - Jacobson, Lisa P.
AU - Napravnik, Sonia
AU - Lucas, Gregory M.
AU - Kirk, Gregory D.
AU - Benson, Constance A.
AU - Collier, Ann C.
AU - Boswell, Stephen
AU - Grasso, Chris
AU - Mayer, Ken
AU - Hogg, Robert S.
AU - Harrigan, Richard
AU - Montaner, Julio
AU - Cescon, Angela
AU - Brooks, John T.
AU - Buchacz, Kate
AU - Gebo, Kelly A.
AU - Rodriguez, Benigno
AU - Thorne, Jennifer E.
AU - Goedert, James J.
AU - Klein, Marina B.
AU - Rourke, Sean B.
AU - Burchell, Ann
AU - Rachlis, Anita R.
AU - Hunter-Mellado, Robert F.
AU - Deeks, Steven G.
AU - Martin, Jeffrey N.
AU - Saag, Michael S.
AU - Mugavero, Michael J.
AU - Willig, James
AU - Eron, Joseph J.
AU - Crane, Heidi M.
AU - Dubrow, Robert
AU - Fiellin, David
AU - Sterling, Timothy R.
AU - Haas, David
AU - Anastos, Kathryn
AU - Turner, Megan
AU - Gange, Stephen J.
AU - Anastos, Kathryn
AU - McKaig, Rosemary G.
AU - Freeman, Aimee M.
AU - Lent, Carol
AU - Van Rompaey, Stephen E.
AU - Webster, Eric
AU - Morton, Liz
AU - Simon, Brenda
AU - Hanna, David B.
AU - Zhang, Jinbing
AU - Jing, Jerry
AU - Modur, Shari
AU - Hanna, David B.
AU - Rebeiro, Peter
AU - Wong, Cherise
AU - Mendes, Adell
PY - 2015
Y1 - 2015
N2 - Background. Human immunodeficiency virus (HIV)-infected adults, particularly those of black race, are at high-risk for end-stage renal disease (ESRD), but contributing factors are evolving. We hypothesized that improvements in HIV treatment have led to declines in risk of ESRD, particularly among HIV-infected blacks. Methods. Using data from the North American AIDS Cohort Collaboration for Research and Design from January 2000 to December 2009, we validated 286 incident ESRD cases using abstracted medical evidence of dialysis (lasting >6 months) or renal transplant. A total of 38 354 HIV-infected adults aged 18-80 years contributed 159 825 person-years (PYs). Age- and sex-standardized incidence ratios (SIRs) were estimated by race. Poisson regression was used to identify predictors of ESRD. Results. HIV-infected ESRD cases were more likely to be of black race, have diabetes mellitus or hypertension, inject drugs, and/or have a prior AIDS-defining illness. The overall SIR was 3.2 (95% confidence interval [CI], 2.8- 3.6) but was significantly higher among black patients (4.5 [95% CI, 3.9-5.2]). ESRD incidence declined from 532 to 303 per 100 000 PYs and 138 to 34 per 100 000 PYs over the time period for blacks and nonblacks, respectively, coincident with notable increases in both the prevalence of viral suppression and the prevalence of ESRD risk factors including diabetes mellitus, hypertension, and hepatitis C virus coinfection. Conclusions. The risk of ESRD remains high among HIV-infected individuals in care but is declining with improvements in virologic suppression. HIV-infected black persons continue to comprise the majority of cases, as a result of higher viral loads, comorbidities, and genetic susceptibility.
AB - Background. Human immunodeficiency virus (HIV)-infected adults, particularly those of black race, are at high-risk for end-stage renal disease (ESRD), but contributing factors are evolving. We hypothesized that improvements in HIV treatment have led to declines in risk of ESRD, particularly among HIV-infected blacks. Methods. Using data from the North American AIDS Cohort Collaboration for Research and Design from January 2000 to December 2009, we validated 286 incident ESRD cases using abstracted medical evidence of dialysis (lasting >6 months) or renal transplant. A total of 38 354 HIV-infected adults aged 18-80 years contributed 159 825 person-years (PYs). Age- and sex-standardized incidence ratios (SIRs) were estimated by race. Poisson regression was used to identify predictors of ESRD. Results. HIV-infected ESRD cases were more likely to be of black race, have diabetes mellitus or hypertension, inject drugs, and/or have a prior AIDS-defining illness. The overall SIR was 3.2 (95% confidence interval [CI], 2.8- 3.6) but was significantly higher among black patients (4.5 [95% CI, 3.9-5.2]). ESRD incidence declined from 532 to 303 per 100 000 PYs and 138 to 34 per 100 000 PYs over the time period for blacks and nonblacks, respectively, coincident with notable increases in both the prevalence of viral suppression and the prevalence of ESRD risk factors including diabetes mellitus, hypertension, and hepatitis C virus coinfection. Conclusions. The risk of ESRD remains high among HIV-infected individuals in care but is declining with improvements in virologic suppression. HIV-infected black persons continue to comprise the majority of cases, as a result of higher viral loads, comorbidities, and genetic susceptibility.
KW - Chronic kidney disease (CKD)
KW - End-stage renal disease (ESRD)
KW - Glomerular filtration rate (GFR)
KW - HIV infection/AIDS
KW - HIV/AIDS
UR - http://www.scopus.com/inward/record.url?scp=84936147324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84936147324&partnerID=8YFLogxK
U2 - 10.1093/cid/ciu919
DO - 10.1093/cid/ciu919
M3 - Article
VL - 60
SP - 941
EP - 949
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 6
ER -