Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults

Amanda Mocroft; Jacqueline Neuhaus; Lars Peters; Lene Ryom; Markus Bickel; Daniel Grint; Janak Koirala; Aleksandra Szymczak; Jens Lundgren; Michael J Ross; Christina M Wyatt; INSIGHT SMART Study Group

doi:10.1371/journal.pone.0040245

Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults

Amanda Mocroft, Jacqueline Neuhaus, Lars Peters, Lene Ryom, Markus Bickel, Daniel Grint, Janak Koirala, Aleksandra Szymczak, Jens Lundgren, Michael J Ross, Christina M Wyatt, INSIGHT SMART Study Group

55 Citations (Scopus)

Abstract

Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-positive individuals. Hepatitis C (HCV) co-infection has been associated with increased risk of CKD, but prior studies lack information on potential mechanisms. We evaluated the association between HCV or hepatitis B (HBV) co-infection and progressive CKD among 3,441 antiretroviral-treated clinical trial participants. Progressive CKD was defined as the composite of end-stage renal disease, renal death, or significant glomerular filtration rate (eGFR) decline (25% decline to eGFR <60 mL/min/1.73 m² or 25% decline with a baseline <60). Generalized Estimating Equations were used to model the odds of progressive CKD. At baseline, 13.8% and 3.3% of participants were co-infected with HCV and HBV, respectively. Median eGFR was 111, and 3.7% developed progressive CKD. After adjustment, the odds of progressive CKD were increased in participants with HCV (OR 1.72, 95% CI 1.07-2.76) or HBV (OR 2.26, 95% CI 1.15-4.44). Participants with undetectable or low HCV-RNA had similar odds of progressive CKD as HCV seronegative participants, while participants with HCV-RNA >800,000 IU/ml had increased odds (OR 3.07; 95% CI 1.60-5.90). Interleukin-6, hyaluronic acid, and the FIB-4 hepatic fibrosis index were higher among participants who developed progressive CKD, but were no longer associated with progressive CKD after adjustment. Future studies should validate the relationship between HCV viremia and CKD.

Original language	English
Journal	PLOS ONE
Volume	7
Issue number	7
Pages (from-to)	e40245
ISSN	1932-6203
DOIs	https://doi.org/10.1371/journal.pone.0040245
Publication status	Published - 20 Jul 2012

Keywords

Adult
Anti-HIV Agents
Coinfection
Disease Progression
Female
Genotype
HIV Seropositivity
Hepatitis B
Hepatitis C
Humans
Liver Cirrhosis
Male
Middle Aged
Prognosis
Renal Insufficiency, Chronic
Viremia
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1371/journal.pone.0040245

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Mocroft, A., Neuhaus, J., Peters, L., Ryom, L., Bickel, M., Grint, D., Koirala, J., Szymczak, A., Lundgren, J., Ross, M. J., Wyatt, C. M., & INSIGHT SMART Study Group (2012). Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. PLOS ONE, 7(7), e40245. https://doi.org/10.1371/journal.pone.0040245

Mocroft, A, Neuhaus, J, Peters, L, Ryom, L, Bickel, M, Grint, D, Koirala, J, Szymczak, A, Lundgren, J, Ross, MJ, Wyatt, CM & INSIGHT SMART Study Group 2012, 'Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults', PLOS ONE, vol. 7, no. 7, pp. e40245. https://doi.org/10.1371/journal.pone.0040245

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abstract = "Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-positive individuals. Hepatitis C (HCV) co-infection has been associated with increased risk of CKD, but prior studies lack information on potential mechanisms. We evaluated the association between HCV or hepatitis B (HBV) co-infection and progressive CKD among 3,441 antiretroviral-treated clinical trial participants. Progressive CKD was defined as the composite of end-stage renal disease, renal death, or significant glomerular filtration rate (eGFR) decline (25% decline to eGFR <60 mL/min/1.73 m2 or 25% decline with a baseline <60). Generalized Estimating Equations were used to model the odds of progressive CKD. At baseline, 13.8% and 3.3% of participants were co-infected with HCV and HBV, respectively. Median eGFR was 111, and 3.7% developed progressive CKD. After adjustment, the odds of progressive CKD were increased in participants with HCV (OR 1.72, 95% CI 1.07-2.76) or HBV (OR 2.26, 95% CI 1.15-4.44). Participants with undetectable or low HCV-RNA had similar odds of progressive CKD as HCV seronegative participants, while participants with HCV-RNA >800,000 IU/ml had increased odds (OR 3.07; 95% CI 1.60-5.90). Interleukin-6, hyaluronic acid, and the FIB-4 hepatic fibrosis index were higher among participants who developed progressive CKD, but were no longer associated with progressive CKD after adjustment. Future studies should validate the relationship between HCV viremia and CKD.",

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author = "Amanda Mocroft and Jacqueline Neuhaus and Lars Peters and Lene Ryom and Markus Bickel and Daniel Grint and Janak Koirala and Aleksandra Szymczak and Jens Lundgren and Ross, {Michael J} and Wyatt, {Christina M} and {INSIGHT SMART Study Group}",

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T1 - Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults

AU - Mocroft, Amanda

AU - Neuhaus, Jacqueline

AU - Peters, Lars

AU - Ryom, Lene

AU - Bickel, Markus

AU - Grint, Daniel

AU - Koirala, Janak

AU - Szymczak, Aleksandra

AU - Lundgren, Jens

AU - Ross, Michael J

AU - Wyatt, Christina M

AU - INSIGHT SMART Study Group

PY - 2012/7/20

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N2 - Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-positive individuals. Hepatitis C (HCV) co-infection has been associated with increased risk of CKD, but prior studies lack information on potential mechanisms. We evaluated the association between HCV or hepatitis B (HBV) co-infection and progressive CKD among 3,441 antiretroviral-treated clinical trial participants. Progressive CKD was defined as the composite of end-stage renal disease, renal death, or significant glomerular filtration rate (eGFR) decline (25% decline to eGFR <60 mL/min/1.73 m2 or 25% decline with a baseline <60). Generalized Estimating Equations were used to model the odds of progressive CKD. At baseline, 13.8% and 3.3% of participants were co-infected with HCV and HBV, respectively. Median eGFR was 111, and 3.7% developed progressive CKD. After adjustment, the odds of progressive CKD were increased in participants with HCV (OR 1.72, 95% CI 1.07-2.76) or HBV (OR 2.26, 95% CI 1.15-4.44). Participants with undetectable or low HCV-RNA had similar odds of progressive CKD as HCV seronegative participants, while participants with HCV-RNA >800,000 IU/ml had increased odds (OR 3.07; 95% CI 1.60-5.90). Interleukin-6, hyaluronic acid, and the FIB-4 hepatic fibrosis index were higher among participants who developed progressive CKD, but were no longer associated with progressive CKD after adjustment. Future studies should validate the relationship between HCV viremia and CKD.

AB - Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-positive individuals. Hepatitis C (HCV) co-infection has been associated with increased risk of CKD, but prior studies lack information on potential mechanisms. We evaluated the association between HCV or hepatitis B (HBV) co-infection and progressive CKD among 3,441 antiretroviral-treated clinical trial participants. Progressive CKD was defined as the composite of end-stage renal disease, renal death, or significant glomerular filtration rate (eGFR) decline (25% decline to eGFR <60 mL/min/1.73 m2 or 25% decline with a baseline <60). Generalized Estimating Equations were used to model the odds of progressive CKD. At baseline, 13.8% and 3.3% of participants were co-infected with HCV and HBV, respectively. Median eGFR was 111, and 3.7% developed progressive CKD. After adjustment, the odds of progressive CKD were increased in participants with HCV (OR 1.72, 95% CI 1.07-2.76) or HBV (OR 2.26, 95% CI 1.15-4.44). Participants with undetectable or low HCV-RNA had similar odds of progressive CKD as HCV seronegative participants, while participants with HCV-RNA >800,000 IU/ml had increased odds (OR 3.07; 95% CI 1.60-5.90). Interleukin-6, hyaluronic acid, and the FIB-4 hepatic fibrosis index were higher among participants who developed progressive CKD, but were no longer associated with progressive CKD after adjustment. Future studies should validate the relationship between HCV viremia and CKD.

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KW - Anti-HIV Agents

KW - Coinfection

KW - Disease Progression

KW - Female

KW - Genotype

KW - HIV Seropositivity

KW - Hepatitis B

KW - Hepatitis C

KW - Humans

KW - Liver Cirrhosis

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Renal Insufficiency, Chronic

KW - Viremia

KW - Young Adult

U2 - 10.1371/journal.pone.0040245

DO - 10.1371/journal.pone.0040245

M3 - Journal article

C2 - 22911697

SN - 1932-6203

VL - 7

SP - e40245

JO - PLoS Computational Biology

JF - PLoS Computational Biology

IS - 7

ER -

Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults

Abstract

Keywords

UN SDGs

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