title: Hepatitis C viremia and the risk of chronic kidney disease in HIV-infected individuals.
abstract: BACKGROUND
  The role of active hepatitis C virus (HCV) replication in chronic kidney disease (CKD) risk has not been clarified.
  
  
  METHODS
  We compared CKD incidence in a large cohort of HIV-infected subjects who were HCV seronegative, HCV viremic (detectable HCV RNA), or HCV aviremic (HCV seropositive, undetectable HCV RNA). Stages 3 and 5 CKD were defined according to standard criteria. Progressive CKD was defined as a sustained 25% glomerular filtration rate (GFR) decrease from baseline to a GFR < 60 mL/min/1.73 m2. We used Cox models to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  A total of 52 602 HCV seronegative, 9508 HCV viremic, and 913 HCV aviremic subjects were included. Compared with HCV seronegative subjects, HCV viremic subjects were at increased risk for stage 3 CKD (adjusted HR 1.36 [95% CI, 1.26, 1.46]), stage 5 CKD (1.95 [1.64, 2.31]), and progressive CKD (1.31 [1.19, 1.44]), while HCV aviremic subjects were also at increased risk for stage 3 CKD (1.19 [0.98, 1.45]), stage 5 CKD (1.69 [1.07, 2.65]), and progressive CKD (1.31 [1.02, 1.68]).
  
  
  CONCLUSIONS
  Compared with HIV-infected subjects who were HCV seronegative, both HCV viremic and HCV aviremic individuals were at increased risk for moderate and advanced CKD.
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Lucas
authors.forename: Yuezhou
authors.initials: Y
authors.lastname: Jing
authors.forename: Mark
authors.initials: M
authors.lastname: Sulkowski
authors.forename: Alison G
authors.initials: AG
authors.lastname: Abraham
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Estrella
authors.forename: Mohamed G
authors.initials: MG
authors.lastname: Atta
authors.forename: Derek M
authors.initials: DM
authors.lastname: Fine
authors.forename: Marina B
authors.initials: MB
authors.lastname: Klein
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Silverberg
authors.forename: M John
authors.initials: MJ
authors.lastname: Gill
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Gebo
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Sterling
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000821:virology; D014481:United States / Q000453:epidemiology; D014766:Viremia / Q000150:complications / Q000453:epidemiology / Q000821:virology
chemical_list: D012367:RNA, Viral
keywords: HIV; chronic kidney disease; cohort study; glomerular filtration rate; hepatitis C RNA; hepatitis C virus; injection drug use
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