Hepatitis C Seropositivity and Kidney Function Decline Among Women With HIV: Data From the Women's Interagency HIV Study

Judith Tsui, Eric Vittinghoff, Kathryn Anastos, Michael Augenbraun, Mary Young, Marek Nowicki, Mardge H. Cohen, Marion G. Peters, Elizabeth Golub, Lynda Szczech

Research output: Contribution to journalArticle

Abstract

Background: How coinfection with hepatitis C virus (HCV) impacts on the trajectory of kidney function in human immunodeficiency virus (HIV)-infected patients is unclear. This study examined the effect of HCV infection on kidney function over time in women infected with HIV. Study Design: Retrospective observational cohort. Setting & Participants: Study sample included participants from the Women's Interagency HIV Study who were HIV infected and had undergone HCV antibody testing and serum creatinine measurement at baseline. Predictor: HCV seropositivity. Outcomes & Measurement: Estimated glomerular filtration rate (eGFR) calculated from semi-annual serum creatinine measurements using the 4-variable Modification of Diet in Renal Diseases (MDRD) Study equation. Linear mixed models were used to evaluate the independent effect of HCV seropositivity on eGFR over time, adjusting for demographic factors, comorbid conditions, illicit drug use, measures of HIV disease status, use of medications, and interactions with baseline low eGFR (2). Results: Of 2,684 HIV-infected women, 952 (35%) were found to be HCV seropositive. In 180 women with chronic kidney disease (CKD) at baseline (eGFR <60 mL/min/1.73 m2), HCV seropositivity was independently associated with a fully adjusted net decrease in eGFR of approximately 5% per year (95% confidence interval, 3.2 to 7.2) relative to women who were seronegative. In contrast, HCV infection was not independently associated with a decrease in eGFR in women without low eGFR at baseline (P <0.001 for interaction). Limitations: The MDRD Study equation has not been validated as a measure of GFR in persons with HIV or HCV infection. Proteinuria was not included in the study analysis. Because the study is observational, effects of residual confounding cannot be excluded. Conclusions: In HIV-infected women with CKD, coinfection with HCV is associated with a modest, but statistically significant, decrease in eGFR over time. More careful monitoring of kidney function may be warranted for HIV-infected patients with CKD who are also coinfected with HCV.

Original languageEnglish (US)
Pages (from-to)43-50
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume54
Issue number1
DOIs
StatePublished - Jul 2009

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Hepatitis C
Hepacivirus
Glomerular Filtration Rate
HIV
Kidney
Virus Diseases
Chronic Renal Insufficiency
Diet Therapy
Coinfection
Creatinine
HIV-2
Hepatitis C Antibodies
Street Drugs
Serum
Proteinuria
Observational Studies
Linear Models
Retrospective Studies
Demography
Confidence Intervals

Keywords

  • Hepatitis C virus
  • human immunodeficiency virus (HIV)
  • kidney diseases
  • women

ASJC Scopus subject areas

  • Nephrology

Cite this

Hepatitis C Seropositivity and Kidney Function Decline Among Women With HIV : Data From the Women's Interagency HIV Study. / Tsui, Judith; Vittinghoff, Eric; Anastos, Kathryn; Augenbraun, Michael; Young, Mary; Nowicki, Marek; Cohen, Mardge H.; Peters, Marion G.; Golub, Elizabeth; Szczech, Lynda.

In: American Journal of Kidney Diseases, Vol. 54, No. 1, 07.2009, p. 43-50.

Research output: Contribution to journalArticle

Tsui, J, Vittinghoff, E, Anastos, K, Augenbraun, M, Young, M, Nowicki, M, Cohen, MH, Peters, MG, Golub, E & Szczech, L 2009, 'Hepatitis C Seropositivity and Kidney Function Decline Among Women With HIV: Data From the Women's Interagency HIV Study', American Journal of Kidney Diseases, vol. 54, no. 1, pp. 43-50. https://doi.org/10.1053/j.ajkd.2009.02.009
Tsui, Judith ; Vittinghoff, Eric ; Anastos, Kathryn ; Augenbraun, Michael ; Young, Mary ; Nowicki, Marek ; Cohen, Mardge H. ; Peters, Marion G. ; Golub, Elizabeth ; Szczech, Lynda. / Hepatitis C Seropositivity and Kidney Function Decline Among Women With HIV : Data From the Women's Interagency HIV Study. In: American Journal of Kidney Diseases. 2009 ; Vol. 54, No. 1. pp. 43-50.
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abstract = "Background: How coinfection with hepatitis C virus (HCV) impacts on the trajectory of kidney function in human immunodeficiency virus (HIV)-infected patients is unclear. This study examined the effect of HCV infection on kidney function over time in women infected with HIV. Study Design: Retrospective observational cohort. Setting & Participants: Study sample included participants from the Women's Interagency HIV Study who were HIV infected and had undergone HCV antibody testing and serum creatinine measurement at baseline. Predictor: HCV seropositivity. Outcomes & Measurement: Estimated glomerular filtration rate (eGFR) calculated from semi-annual serum creatinine measurements using the 4-variable Modification of Diet in Renal Diseases (MDRD) Study equation. Linear mixed models were used to evaluate the independent effect of HCV seropositivity on eGFR over time, adjusting for demographic factors, comorbid conditions, illicit drug use, measures of HIV disease status, use of medications, and interactions with baseline low eGFR (2). Results: Of 2,684 HIV-infected women, 952 (35{\%}) were found to be HCV seropositive. In 180 women with chronic kidney disease (CKD) at baseline (eGFR <60 mL/min/1.73 m2), HCV seropositivity was independently associated with a fully adjusted net decrease in eGFR of approximately 5{\%} per year (95{\%} confidence interval, 3.2 to 7.2) relative to women who were seronegative. In contrast, HCV infection was not independently associated with a decrease in eGFR in women without low eGFR at baseline (P <0.001 for interaction). Limitations: The MDRD Study equation has not been validated as a measure of GFR in persons with HIV or HCV infection. Proteinuria was not included in the study analysis. Because the study is observational, effects of residual confounding cannot be excluded. Conclusions: In HIV-infected women with CKD, coinfection with HCV is associated with a modest, but statistically significant, decrease in eGFR over time. More careful monitoring of kidney function may be warranted for HIV-infected patients with CKD who are also coinfected with HCV.",
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AU - Augenbraun, Michael

AU - Young, Mary

AU - Nowicki, Marek

AU - Cohen, Mardge H.

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N2 - Background: How coinfection with hepatitis C virus (HCV) impacts on the trajectory of kidney function in human immunodeficiency virus (HIV)-infected patients is unclear. This study examined the effect of HCV infection on kidney function over time in women infected with HIV. Study Design: Retrospective observational cohort. Setting & Participants: Study sample included participants from the Women's Interagency HIV Study who were HIV infected and had undergone HCV antibody testing and serum creatinine measurement at baseline. Predictor: HCV seropositivity. Outcomes & Measurement: Estimated glomerular filtration rate (eGFR) calculated from semi-annual serum creatinine measurements using the 4-variable Modification of Diet in Renal Diseases (MDRD) Study equation. Linear mixed models were used to evaluate the independent effect of HCV seropositivity on eGFR over time, adjusting for demographic factors, comorbid conditions, illicit drug use, measures of HIV disease status, use of medications, and interactions with baseline low eGFR (2). Results: Of 2,684 HIV-infected women, 952 (35%) were found to be HCV seropositive. In 180 women with chronic kidney disease (CKD) at baseline (eGFR <60 mL/min/1.73 m2), HCV seropositivity was independently associated with a fully adjusted net decrease in eGFR of approximately 5% per year (95% confidence interval, 3.2 to 7.2) relative to women who were seronegative. In contrast, HCV infection was not independently associated with a decrease in eGFR in women without low eGFR at baseline (P <0.001 for interaction). Limitations: The MDRD Study equation has not been validated as a measure of GFR in persons with HIV or HCV infection. Proteinuria was not included in the study analysis. Because the study is observational, effects of residual confounding cannot be excluded. Conclusions: In HIV-infected women with CKD, coinfection with HCV is associated with a modest, but statistically significant, decrease in eGFR over time. More careful monitoring of kidney function may be warranted for HIV-infected patients with CKD who are also coinfected with HCV.

AB - Background: How coinfection with hepatitis C virus (HCV) impacts on the trajectory of kidney function in human immunodeficiency virus (HIV)-infected patients is unclear. This study examined the effect of HCV infection on kidney function over time in women infected with HIV. Study Design: Retrospective observational cohort. Setting & Participants: Study sample included participants from the Women's Interagency HIV Study who were HIV infected and had undergone HCV antibody testing and serum creatinine measurement at baseline. Predictor: HCV seropositivity. Outcomes & Measurement: Estimated glomerular filtration rate (eGFR) calculated from semi-annual serum creatinine measurements using the 4-variable Modification of Diet in Renal Diseases (MDRD) Study equation. Linear mixed models were used to evaluate the independent effect of HCV seropositivity on eGFR over time, adjusting for demographic factors, comorbid conditions, illicit drug use, measures of HIV disease status, use of medications, and interactions with baseline low eGFR (2). Results: Of 2,684 HIV-infected women, 952 (35%) were found to be HCV seropositive. In 180 women with chronic kidney disease (CKD) at baseline (eGFR <60 mL/min/1.73 m2), HCV seropositivity was independently associated with a fully adjusted net decrease in eGFR of approximately 5% per year (95% confidence interval, 3.2 to 7.2) relative to women who were seronegative. In contrast, HCV infection was not independently associated with a decrease in eGFR in women without low eGFR at baseline (P <0.001 for interaction). Limitations: The MDRD Study equation has not been validated as a measure of GFR in persons with HIV or HCV infection. Proteinuria was not included in the study analysis. Because the study is observational, effects of residual confounding cannot be excluded. Conclusions: In HIV-infected women with CKD, coinfection with HCV is associated with a modest, but statistically significant, decrease in eGFR over time. More careful monitoring of kidney function may be warranted for HIV-infected patients with CKD who are also coinfected with HCV.

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