Immunosuppression, hepatitis C infection, and acute renal failure in HIV-infected patients.
BACKGROUND
Low CD4 cell counts predict HIV-related morbidity and mortality and may be associated with acute renal failure (ARF).


OBJECTIVE
To estimate the effect of CD4 cell count on the incidence rate (IR) of ARF in ambulatory HIV-infected patients with access to highly active antiretroviral therapy.


METHODS
Observational clinical cohort of HIV-infected patients recruited from a university-based infectious diseases clinic, between 2000 and 2002, and followed up until December 31, 2002. Poisson log-linear regression models were used to calculate ARF IRs, IR differences, and IR ratios.


RESULTS
The mean age of the 705 study participants was 40 years, two thirds were male, and 61% were African American. Incidence rates of ARF were higher at lower CD4 cell counts and among patients who were coinfected with hepatitis C. Patients with hepatitis C coinfection who also had low CD4 cell counts had the highest adjusted IR of ARF.


CONCLUSIONS
Immunosuppression and hepatitis C virus coinfection are associated with increased IRs of ARF in ambulatory HIV-1-infected patients.
Franceschini
Nora
N
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC 27514, USA. noraf@unc.edu
Napravnik
Sonia
S
Finn
William F
WF
Szczech
Lynda A
LA
Eron
Joseph J
JJ
D058186:Acute Kidney Injury / Q000150:complications / Q000276:immunology*; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009657:North Carolina