Hepatitis B and C co-infection are independent predictors of progressive kidney disease in hiv-positive, antiretroviral-treated adults

Amanda Mocroft, Jacqueline Neuhaus, Lars Peters, Lene Ryom, Markus Bickel, Daniel Grint, Janak Koirala, Aleksandra Szymczak, Jens Lundgren, Michael J. Ross, Christina M. Wyatt

Research output: Contribution to journalArticle

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Abstract

Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-positive individuals. Hepatitis C (HCV) co-infection has been associated with increased risk of CKD, but prior studies lack information on potential mechanisms. We evaluated the association between HCV or hepatitis B (HBV) co-infection and progressive CKD among 3,441 antiretroviral-treated clinical trial participants. Progressive CKD was defined as the composite of end-stage renal disease, renal death, or significant glomerular filtration rate (eGFR) decline (25% decline to eGFR <60 mL/min/1.73 m2 or 25% decline with a baseline <60). Generalized Estimating Equations were used to model the odds of progressive CKD. At baseline, 13.8% and 3.3% of participants were co-infected with HCV and HBV, respectively. Median eGFR was 111, and 3.7% developed progressive CKD. After adjustment, the odds of progressive CKD were increased in participants with HCV (OR 1.72, 95% CI 1.07-2.76) or HBV (OR 2.26, 95% CI 1.15-4.44). Participants with undetectable or low HCV-RNA had similar odds of progressive CKD as HCV seronegative participants, while participants with HCV-RNA >800,000 IU/ml had increased odds (OR 3.07; 95% CI 1.60-5.90). Interleukin-6, hyaluronic acid, and the FIB-4 hepatic fibrosis index were higher among participants who developed progressive CKD, but were no longer associated with progressive CKD after adjustment. Future studies should validate the relationship between HCV viremia and CKD.

Original languageEnglish (US)
Article numbere40245
JournalPLoS One
Volume7
Issue number7
DOIs
StatePublished - Jul 20 2012
Externally publishedYes

Fingerprint

hepatitis C
hepatitis B
Kidney Diseases
Hepatitis C
kidney diseases
Hepatitis B
Coinfection
mixed infection
Chronic Renal Insufficiency
Viremia
hyaluronic acid
liver cirrhosis
Hyaluronic Acid
glomerular filtration rate
Glomerular Filtration Rate
viremia
Chronic Kidney Failure
Interleukin-6
interleukin-6
Fibrosis

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Hepatitis B and C co-infection are independent predictors of progressive kidney disease in hiv-positive, antiretroviral-treated adults. / Mocroft, Amanda; Neuhaus, Jacqueline; Peters, Lars; Ryom, Lene; Bickel, Markus; Grint, Daniel; Koirala, Janak; Szymczak, Aleksandra; Lundgren, Jens; Ross, Michael J.; Wyatt, Christina M.

In: PLoS One, Vol. 7, No. 7, e40245, 20.07.2012.

Research output: Contribution to journalArticle

Mocroft, A, Neuhaus, J, Peters, L, Ryom, L, Bickel, M, Grint, D, Koirala, J, Szymczak, A, Lundgren, J, Ross, MJ & Wyatt, CM 2012, 'Hepatitis B and C co-infection are independent predictors of progressive kidney disease in hiv-positive, antiretroviral-treated adults', PLoS One, vol. 7, no. 7, e40245. https://doi.org/10.1371/journal.pone.0040245
Mocroft, Amanda ; Neuhaus, Jacqueline ; Peters, Lars ; Ryom, Lene ; Bickel, Markus ; Grint, Daniel ; Koirala, Janak ; Szymczak, Aleksandra ; Lundgren, Jens ; Ross, Michael J. ; Wyatt, Christina M. / Hepatitis B and C co-infection are independent predictors of progressive kidney disease in hiv-positive, antiretroviral-treated adults. In: PLoS One. 2012 ; Vol. 7, No. 7.
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