title: Ascertainment and verification of end-stage renal disease and end-stage liver disease in the north american AIDS cohort collaboration on research and design.
abstract: The burden of HIV disease has shifted from traditional AIDS-defining illnesses to serious non-AIDS-defining comorbid conditions. Research aimed at improving HIV-related comorbid disease outcomes requires well-defined, verified clinical endpoints. We developed methods to ascertain and verify end-stage renal disease (ESRD) and end-stage liver disease (ESLD) and validated screening algorithms within the largest HIV cohort collaboration in North America (NA-ACCORD). Individuals who screened positive among all participants in twelve cohorts enrolled between January 1996 and December 2009 underwent medical record review to verify incident ESRD or ESLD using standardized protocols. We randomly sampled 6% of contributing cohorts to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ESLD and ESRD screening algorithms in a validation subcohort. Among 43,433 patients screened for ESRD, 822 screened positive of which 620 met clinical criteria for ESRD. The algorithm had 100% sensitivity, 99% specificity, 82% PPV, and 100% NPV for ESRD. Among 41,463 patients screened for ESLD, 2,024 screened positive of which 645 met diagnostic criteria for ESLD. The algorithm had 100% sensitivity, 95% specificity, 27% PPV, and 100% NPV for ESLD. Our methods proved robust for ascertainment of ESRD and ESLD in persons infected with HIV.
authors: Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA ; Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
authors: Mari M
authors: MM
authors: Kitahata
authors: Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA ; Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
authors: Daniel R
authors: DR
authors: Drozd
authors: Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA ; Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
authors: Heidi M
authors: HM
authors: Crane
authors: Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
authors: Stephen E
authors: SE
authors: Van Rompaey
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Keri N
authors: KN
authors: Althoff
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Stephen J
authors: SJ
authors: Gange
authors: Division of Infectious Diseases Chronic Viral Illness Service, Department of Medicine, McGill University, Montreal, QC, Canada.
authors: Marina B
authors: MB
authors: Klein
authors: Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
authors: Gregory M
authors: GM
authors: Lucas
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Alison G
authors: AG
authors: Abraham
authors: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia VA Medical Center, Philadelphia, PA 19104, USA.
authors: Vincent
authors: V
authors: Lo Re
authors: Medical Education and Biomedical Informatics, School of Medicine, University of Washington, Seattle, WA 98109, USA.
authors: Justin
authors: J
authors: McReynolds
authors: Medical Education and Biomedical Informatics, School of Medicine, University of Washington, Seattle, WA 98109, USA ; Biobehavioral Nursing and Health Systems, Department of Nursing, University of Washington, Seattle, WA 98195, USA.
authors: William B
authors: WB
authors: Lober
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Adell
authors: A
authors: Mendes
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Sharada P
authors: SP
authors: Modur
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Yuezhou
authors: Y
authors: Jing
authors: Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
authors: Elizabeth J
authors: EJ
authors: Morton
authors: Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
authors: Margaret A
authors: MA
authors: Griffith
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Aimee M
authors: AM
authors: Freeman
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA ; Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
authors: Richard D
authors: RD
authors: Moore