@article{dde24c3e42e14d278cd8298bb504d304,
title = "Host APOL1 genotype is independently associated with proteinuria in HIV infection",
abstract = "Proteinuria is associated with adverse clinical outcomes in HIV infection. Here we evaluated whether APOL1 risk alleles, previously associated with advanced kidney disease, are independently associated with proteinuria in HIV infection in a cross-sectional study of HIV-infected women in the Women's Interagency HIV Study. We estimated the percent difference in urine protein excretion and odds of proteinuria (≥200 mg/g) associated with two versus one or no APOL1 risk allele using linear and logistic regression, respectively. Of 1285 women successfully genotyped, 379 carried one and 80 carried two risk alleles. Proteinuria was present in 124 women, 78 of whom had proteinuria confirmed on a second sample. In women without prior AIDS, two risk alleles were independently associated with a 69% higher urine protein excretion (95% confidence interval (CI): 36, 108) and five-fold higher odds of proteinuria (95% CI: 2.45, 10.37) as compared with one or no risk allele. No association was found in women with prior AIDS. Analyses in which women with impaired kidney function were excluded and proteinuria was confirmed by a second urine sample yielded similar estimates. Thus, APOL1 risk alleles are associated with significant proteinuria in HIV-infected persons without prior clinical AIDS, independent of clinical factors traditionally associated with proteinuria. Trials are needed to determine whether APOL1 genotyping identifies individuals who could benefit from earlier intervention to prevent overt renal disease.",
keywords = "HIV, genetic renal disease, kidney disease, proteinuria",
author = "Estrella, {Michelle M.} and Wyatt, {Christina M.} and Pearce, {C. Leigh} and Man Li and Shlipak, {Michael G.} and Aouizerat, {Bradley E.} and Deborah Gustafson and Cohen, {Mardge H.} and Gange, {Stephen J.} and Kao, {W. H.Linda} and Parekh, {Rulan S.}",
note = "Funding Information: This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (1 K23DK08131 to MME) and through a Mini-Grant provided by the National Kidney Foundation of Maryland (to MME). Data in this manuscript were collected by the Women{\textquoteright}s Interagency HIV Study (WIHS) Collaborative Study Group with centers (Principal Investigators) at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington DC, Metropolitan Consortium (Mary Young); The Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); and Data Coordinating Center (Stephen Gange). The WIHS is funded by the National Institute of Allergy and Infectious Diseases (UO1-AI-35004, UO1-AI-31834, UO1-AI-34994, UO1-AI-34989, UO1-AI-34993, and UO1-AI-42590) and by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (UO1-HD-32632). The study is cofunded by the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders. Funding is also provided by the National Center for Research Resources (UCSF-CTSI Grant number UL1 RR024131). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.",
year = "2013",
month = oct,
doi = "10.1038/ki.2013.203",
language = "English (US)",
volume = "84",
pages = "834--840",
journal = "Kidney international",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "4",
}