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Influence of hepatitis C virus co-infection and hepatitis C virus treatment on risk of chronic kidney disease in HIV-positive persons
A. Mocroft, L. Ryom, C. Oprea, Q. Li, A. Rauch, C. Boesecke, V. Uzdaviniene, D. Sedlacek, JM. Llibre, K. Lacombe, LN. Nielsen, E. Florence, I. Aho, N. Chkhartishvili, J. Szlavik, G. Dragovic, C. Leen, H. Sambatakou, T. Staub, M. Laguno, H....
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, práce podpořená grantem
NLK
Free Medical Journals
od 1997 do Před 1 rokem
Open Access Digital Library
od 1997-11-11
- MeSH
- antivirové látky * terapeutické užití MeSH
- chronická hepatitida C * komplikace farmakoterapie MeSH
- chronická renální insuficience * komplikace epidemiologie MeSH
- Hepacivirus MeSH
- HIV infekce * komplikace farmakoterapie MeSH
- koinfekce * farmakoterapie MeSH
- lidé MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Hepatitis C virus (HCV) infection has been associated with increased risk of chronic kidney disease (CKD). We investigated the impact of HCV cure on CKD in HIV-positive persons in the EuroSIDA study. METHODS: HIV-positive persons with known HCV status and at least three serum creatinine measurements after 1/1/2004 were compared based on time-updated HCV-RNA and HCV treatment: anti-HCV-negative, spontaneously cleared HCV, chronic untreated HCV, successfully treated HCV, and HCV-RNA positive after HCV treatment. Poisson regression compared incidence rates of CKD [confirmed (>3 months apart) eGFR <60 ml/min per 1.73 m] between HCV strata. RESULTS: Fourteen thousand, seven hundred and fifty-four persons were included; at baseline 9273 (62.9%) were HCV-Ab negative, 696 (4.7%) spontaneous clearers, 3021 (20.5%) chronically infected, 922 (6.2%) successfully treated and 842 (5.7%) HCV-RNA positive after treatment. During 115 335 person-years of follow-up (PYFU), 1128 (7.6%) developed CKD; crude incidence 9.8/1000 PYFU (95% CI 9.2-10.4). After adjustment, persons anti-HCV negative [adjusted incidence rate ratio (aIRR) 0.59; 95% CI 0.46-0.75] and spontaneous clearers (aIRR 0.67; 95% CI 0.47-0.97) had significantly lower rates of CKD compared with those cured whereas persons chronically infected (aIRR 0.85; 95% CI 0.65-1.12) and HCV-RNA positive after treatment (aIRR 0.71; 95% CI 0.49-1.04) had similar rates. Analysis in those without F3/F4 liver fibrosis using a more rigorous definition of CKD showed similar results. CONCLUSION: This large study found no evidence that successful HCV treatment reduced CKD incidence. Confounding by indication, where those with highest risk of CKD were prioritized for HCV treatment in the DAA era, may contribute to these findings.
Centre for Clinical Research Epidemiology Modelling and Evaluation London United Kingdom
Centre Hospitalier de Luxembourg Service des Maladies Infectieuses Luxemburg
Charles University Hospital Plzen Plzen Czech Republic
Department of Clinical Microbiology and Infectious Diseases Hadassah Hospital Jerusalem Israel
Department of Infectious Diseases Bern University Hospital Bern Switzerland
Department of Infectious Diseases Ljubljana University Medical Center Ljubljana Slovenia
Department of Medicine 1 University Hospital Bonn Bonn Germany
Helsinki University Hospital Division of Infectious Diseases Helsinki Finland
Hospital Clinic Infectious Diseases Service Barcelona Spain
Infectious Diseases AIDS and Clinical Immunology Research Center Tbilisi Georgia
Institute of Tropical Medicine Antwerp Belgium
Ippokration General Hospital Athens Greece
Nordsjællands Hospital Hillerød Denmark
Sorbonne Université IPLESP Inserm UMR S AP HP France
South Pest Hospital Centre National Institute for Infectology and Haematology Hungary Budapest
University Hospital Germans Trias i Pujol Badalona Barcelona Spain
University of Belgrade School of Medicine Belgrade Serbia
Victor Babes Clinical Hospital for Infectious and Tropical Diseases Bucharest Romania
Vilnius University Hospital Santariskiu Klinikos Vilnius Lithuania
Citace poskytuje Crossref.org
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- $a BACKGROUND: Hepatitis C virus (HCV) infection has been associated with increased risk of chronic kidney disease (CKD). We investigated the impact of HCV cure on CKD in HIV-positive persons in the EuroSIDA study. METHODS: HIV-positive persons with known HCV status and at least three serum creatinine measurements after 1/1/2004 were compared based on time-updated HCV-RNA and HCV treatment: anti-HCV-negative, spontaneously cleared HCV, chronic untreated HCV, successfully treated HCV, and HCV-RNA positive after HCV treatment. Poisson regression compared incidence rates of CKD [confirmed (>3 months apart) eGFR <60 ml/min per 1.73 m] between HCV strata. RESULTS: Fourteen thousand, seven hundred and fifty-four persons were included; at baseline 9273 (62.9%) were HCV-Ab negative, 696 (4.7%) spontaneous clearers, 3021 (20.5%) chronically infected, 922 (6.2%) successfully treated and 842 (5.7%) HCV-RNA positive after treatment. During 115 335 person-years of follow-up (PYFU), 1128 (7.6%) developed CKD; crude incidence 9.8/1000 PYFU (95% CI 9.2-10.4). After adjustment, persons anti-HCV negative [adjusted incidence rate ratio (aIRR) 0.59; 95% CI 0.46-0.75] and spontaneous clearers (aIRR 0.67; 95% CI 0.47-0.97) had significantly lower rates of CKD compared with those cured whereas persons chronically infected (aIRR 0.85; 95% CI 0.65-1.12) and HCV-RNA positive after treatment (aIRR 0.71; 95% CI 0.49-1.04) had similar rates. Analysis in those without F3/F4 liver fibrosis using a more rigorous definition of CKD showed similar results. CONCLUSION: This large study found no evidence that successful HCV treatment reduced CKD incidence. Confounding by indication, where those with highest risk of CKD were prioritized for HCV treatment in the DAA era, may contribute to these findings.
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