The impact of hepatitis C coinfection on kidney disease related to human immunodeficiency virus (HIV)

A biopsy study

Elizabeth George, Girish N. Nadkarni, Michelle M. Estrella, Gregory M Lucas, C John Sperati, Mohamed Atta, Derek M Fine

Research output: Contribution to journalArticle

Abstract

Approximately 1 in 4 individuals infected with the human immunodeficiency virus (HIV) in the United States is coinfected with the hepatitis C virus. Both conditions increase the risk for the development and progression of kidney disease. The effect, however, of coexisting HIV and hepatitis C infection on the spectrum and progression of kidney disease is not well known. To compare the clinical features, histopathologic kidney diagnoses, and proportion of individuals progressing to end-stage kidney disease (ESKD), we reviewed the clinical records of HIV-infected individuals with and without hepatitis C coinfection who underwent ultrasound-guided percutaneous kidney biopsies between February 7, 1995, and March 30, 2009.Of the 249 HIV-infected individuals included in this study, 58% were coinfected with hepatitis C. Coinfected individuals were older (mean age, 46 ± 7 vs. 44 ± 10 yr, respectively; p <0.01) and more likely to have used illicit drugs (85% vs. 14%, respectively; p <0.01) compared to HIV-infected individuals without hepatitis C. HIV-associated nephropathy was the most common histopathologic diagnosis in both groups. Immune-complex glomerulonephritides (ICGNs), including lupus-like nephritis, postinfectious glomerulonephritis, membranous glomerulopathy, membranoproliferative glomerulonephritis, IgA nephropathy, and nonspecific ICGNs, occurred more frequently in individuals coinfected with hepatitis C than in those not coinfected (22% vs. 11%, respectively; p = 0.02). Although the proportion of those who died was similar between the 2 groups, hepatitis C coinfection was independently associated with a greater risk of progression to ESKD (hazard ratio, 1.81; 95% confidence interval, 1.09-2.99; p = 0.02).The current study demonstrates that coinfection with hepatitis C in individuals infected with HIV predisposes these individuals to immune-complex glomerulonephritides and is associated with increased risk of ESKD in the biopsied population.

Original languageEnglish (US)
Pages (from-to)289-295
Number of pages7
JournalMedicine
Volume90
Issue number5
DOIs
StatePublished - Sep 2011

Fingerprint

Kidney Diseases
Hepatitis C
Coinfection
HIV
Biopsy
Glomerulonephritis
Antigen-Antibody Complex
Chronic Kidney Failure
AIDS-Associated Nephropathy
Membranoproliferative Glomerulonephritis
Kidney
Membranous Glomerulonephritis
Lupus Nephritis
Street Drugs
Hepacivirus
Immunoglobulin A
Confidence Intervals
Infection
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The impact of hepatitis C coinfection on kidney disease related to human immunodeficiency virus (HIV) : A biopsy study. / George, Elizabeth; Nadkarni, Girish N.; Estrella, Michelle M.; Lucas, Gregory M; Sperati, C John; Atta, Mohamed; Fine, Derek M.

In: Medicine, Vol. 90, No. 5, 09.2011, p. 289-295.

Research output: Contribution to journalArticle

@article{290248e736424140abe485bd4402e85c,
title = "The impact of hepatitis C coinfection on kidney disease related to human immunodeficiency virus (HIV): A biopsy study",
abstract = "Approximately 1 in 4 individuals infected with the human immunodeficiency virus (HIV) in the United States is coinfected with the hepatitis C virus. Both conditions increase the risk for the development and progression of kidney disease. The effect, however, of coexisting HIV and hepatitis C infection on the spectrum and progression of kidney disease is not well known. To compare the clinical features, histopathologic kidney diagnoses, and proportion of individuals progressing to end-stage kidney disease (ESKD), we reviewed the clinical records of HIV-infected individuals with and without hepatitis C coinfection who underwent ultrasound-guided percutaneous kidney biopsies between February 7, 1995, and March 30, 2009.Of the 249 HIV-infected individuals included in this study, 58{\%} were coinfected with hepatitis C. Coinfected individuals were older (mean age, 46 ± 7 vs. 44 ± 10 yr, respectively; p <0.01) and more likely to have used illicit drugs (85{\%} vs. 14{\%}, respectively; p <0.01) compared to HIV-infected individuals without hepatitis C. HIV-associated nephropathy was the most common histopathologic diagnosis in both groups. Immune-complex glomerulonephritides (ICGNs), including lupus-like nephritis, postinfectious glomerulonephritis, membranous glomerulopathy, membranoproliferative glomerulonephritis, IgA nephropathy, and nonspecific ICGNs, occurred more frequently in individuals coinfected with hepatitis C than in those not coinfected (22{\%} vs. 11{\%}, respectively; p = 0.02). Although the proportion of those who died was similar between the 2 groups, hepatitis C coinfection was independently associated with a greater risk of progression to ESKD (hazard ratio, 1.81; 95{\%} confidence interval, 1.09-2.99; p = 0.02).The current study demonstrates that coinfection with hepatitis C in individuals infected with HIV predisposes these individuals to immune-complex glomerulonephritides and is associated with increased risk of ESKD in the biopsied population.",
author = "Elizabeth George and Nadkarni, {Girish N.} and Estrella, {Michelle M.} and Lucas, {Gregory M} and Sperati, {C John} and Mohamed Atta and Fine, {Derek M}",
year = "2011",
month = "9",
doi = "10.1097/MD.0b013e31822f5915",
language = "English (US)",
volume = "90",
pages = "289--295",
journal = "Medicine",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - The impact of hepatitis C coinfection on kidney disease related to human immunodeficiency virus (HIV)

T2 - A biopsy study

AU - George, Elizabeth

AU - Nadkarni, Girish N.

AU - Estrella, Michelle M.

AU - Lucas, Gregory M

AU - Sperati, C John

AU - Atta, Mohamed

AU - Fine, Derek M

PY - 2011/9

Y1 - 2011/9

N2 - Approximately 1 in 4 individuals infected with the human immunodeficiency virus (HIV) in the United States is coinfected with the hepatitis C virus. Both conditions increase the risk for the development and progression of kidney disease. The effect, however, of coexisting HIV and hepatitis C infection on the spectrum and progression of kidney disease is not well known. To compare the clinical features, histopathologic kidney diagnoses, and proportion of individuals progressing to end-stage kidney disease (ESKD), we reviewed the clinical records of HIV-infected individuals with and without hepatitis C coinfection who underwent ultrasound-guided percutaneous kidney biopsies between February 7, 1995, and March 30, 2009.Of the 249 HIV-infected individuals included in this study, 58% were coinfected with hepatitis C. Coinfected individuals were older (mean age, 46 ± 7 vs. 44 ± 10 yr, respectively; p <0.01) and more likely to have used illicit drugs (85% vs. 14%, respectively; p <0.01) compared to HIV-infected individuals without hepatitis C. HIV-associated nephropathy was the most common histopathologic diagnosis in both groups. Immune-complex glomerulonephritides (ICGNs), including lupus-like nephritis, postinfectious glomerulonephritis, membranous glomerulopathy, membranoproliferative glomerulonephritis, IgA nephropathy, and nonspecific ICGNs, occurred more frequently in individuals coinfected with hepatitis C than in those not coinfected (22% vs. 11%, respectively; p = 0.02). Although the proportion of those who died was similar between the 2 groups, hepatitis C coinfection was independently associated with a greater risk of progression to ESKD (hazard ratio, 1.81; 95% confidence interval, 1.09-2.99; p = 0.02).The current study demonstrates that coinfection with hepatitis C in individuals infected with HIV predisposes these individuals to immune-complex glomerulonephritides and is associated with increased risk of ESKD in the biopsied population.

AB - Approximately 1 in 4 individuals infected with the human immunodeficiency virus (HIV) in the United States is coinfected with the hepatitis C virus. Both conditions increase the risk for the development and progression of kidney disease. The effect, however, of coexisting HIV and hepatitis C infection on the spectrum and progression of kidney disease is not well known. To compare the clinical features, histopathologic kidney diagnoses, and proportion of individuals progressing to end-stage kidney disease (ESKD), we reviewed the clinical records of HIV-infected individuals with and without hepatitis C coinfection who underwent ultrasound-guided percutaneous kidney biopsies between February 7, 1995, and March 30, 2009.Of the 249 HIV-infected individuals included in this study, 58% were coinfected with hepatitis C. Coinfected individuals were older (mean age, 46 ± 7 vs. 44 ± 10 yr, respectively; p <0.01) and more likely to have used illicit drugs (85% vs. 14%, respectively; p <0.01) compared to HIV-infected individuals without hepatitis C. HIV-associated nephropathy was the most common histopathologic diagnosis in both groups. Immune-complex glomerulonephritides (ICGNs), including lupus-like nephritis, postinfectious glomerulonephritis, membranous glomerulopathy, membranoproliferative glomerulonephritis, IgA nephropathy, and nonspecific ICGNs, occurred more frequently in individuals coinfected with hepatitis C than in those not coinfected (22% vs. 11%, respectively; p = 0.02). Although the proportion of those who died was similar between the 2 groups, hepatitis C coinfection was independently associated with a greater risk of progression to ESKD (hazard ratio, 1.81; 95% confidence interval, 1.09-2.99; p = 0.02).The current study demonstrates that coinfection with hepatitis C in individuals infected with HIV predisposes these individuals to immune-complex glomerulonephritides and is associated with increased risk of ESKD in the biopsied population.

UR - http://www.scopus.com/inward/record.url?scp=80052463838&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052463838&partnerID=8YFLogxK

U2 - 10.1097/MD.0b013e31822f5915

DO - 10.1097/MD.0b013e31822f5915

M3 - Article

VL - 90

SP - 289

EP - 295

JO - Medicine

JF - Medicine

SN - 0025-7974

IS - 5

ER -