Trends in nephropathy among HIV-infected patients.
BACKGROUND
Nephropathy complicates the course and adversely impacts on the prognosis of HIV-infected patients. We examined trends and correlates of all-cause nephropathy (ACN).


METHODS
Correlates of and trends in ACN were examined in the entire Adult/Adolescent Spectrum of HIV Disease longitudinal observational cohort. Patients were enrolled and followed in the cohort for a median period of 3 years between January 1990 and December 2003 in 11 US metropolitan areas.


RESULTS
The incidence of ACN rose among HIV-infected individuals through the mid-1990s, then declined. The proportion of patients with ACN at the time of death increased over the study period. Black race, injection-drug use (IDU), indinavir, hypertension, diabetes, decreased CD4+ lymphocyte count, increased viral load, and increased age were all highly associated with ACN.


CONCLUSIONS
Nephropathy represents an important health disparity impacting HIV-infected blacks and IDU with implications for mortality.
Buskin
Susan E
SE
HIV/AIDS Program, Prevention Division, Public Health-Seattle and King County, Seattle, Washington, USA. susan.buskin@kingcounty.gov
Torno
Mauro S
MS
Talkington
Deborah F
DF
Zhang
Ming
M
Jones
Jeffrey L
JL
Butler
Jay C
JC
McNaghten
A D
AD
Dworkin
Mark S
MS
D016263:AIDS-Associated Nephropathy / Q000453:epidemiology* / Q000208:ethnology; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D019562:Viral Load