BACKGROUND: Prognosis of HIV-infected patients on dialysis has improved. Few studies have compared survival between HIV-infected and HIV-negative patients on dialysis in the combined antiretroviral therapy (cART) era. We compared the outcome of HIV-infected patients on dialysis with a matched HIV-negative cohort. METHODS: National, multicenter, retrospective cohort study of HIV-infected patients starting dialysis in Spain (1999-2006). Matching criteria for HIV-negative patients were dialysis center, year of starting dialysis, age, sex, and race. RESULTS: The study population comprised 122 patients, 66 HIV-infected, and 66 HIV-negative patients. Median age was 41 years, and all but 4 HIV-infected patients were white. HIV-associated nephropathy was only present in 4 cases. HIV-infected patients were less frequently included on the kidney transplantation waiting list (17% vs 62%, P < 0.001). They also had more hepatitis C virus coinfection (76% vs 11%, P < 0.001), fewer cardiovascular events (62% vs 88%, P = 0.001), fewer kidney transplants (4.5% vs 38%, P < 0.001), and higher mortality (32% vs 1.5%, P < 0.001). Survival rates [95% confidence interval (CI)] at 1, 3, and 5 years for HIV-infected patients were 95.2% (89.9%-100%), 71.7% (59.7%-83.7%), and 62.7% (46.6%-78.8%). Five-year survival for HIV-negative patients was 94.4% (83.8%-100%) (P < 0.001). Multivariate analysis revealed the following variables to be associated with death in HIV-infected patients: peritoneal dialysis vs hemodialysis [hazard ratio; (95% CI): 2.88 (1.16-7.17)] and being on effective cART [hazard ratio (95% CI): 0.39 (0.16-0.97)]. CONCLUSIONS: Medium-term survival of HIV-infected patients on dialysis was lower than that of matched HIV-negative patients. Fewer HIV-infected patients had access to kidney transplantation. Being on effective cART improves survival. Further studies are needed to determine whether peritoneal dialysis increases mortality.
BACKGROUND: Prognosis of HIV-infectedpatients on dialysis has improved. Few studies have compared survival between HIV-infected and HIV-negative patients on dialysis in the combined antiretroviral therapy (cART) era. We compared the outcome of HIV-infectedpatients on dialysis with a matched HIV-negative cohort. METHODS: National, multicenter, retrospective cohort study of HIV-infectedpatients starting dialysis in Spain (1999-2006). Matching criteria for HIV-negative patients were dialysis center, year of starting dialysis, age, sex, and race. RESULTS: The study population comprised 122 patients, 66 HIV-infected, and 66 HIV-negative patients. Median age was 41 years, and all but 4 HIV-infectedpatients were white. HIV-associated nephropathy was only present in 4 cases. HIV-infectedpatients were less frequently included on the kidney transplantation waiting list (17% vs 62%, P < 0.001). They also had more hepatitis C virus coinfection (76% vs 11%, P < 0.001), fewer cardiovascular events (62% vs 88%, P = 0.001), fewer kidney transplants (4.5% vs 38%, P < 0.001), and higher mortality (32% vs 1.5%, P < 0.001). Survival rates [95% confidence interval (CI)] at 1, 3, and 5 years for HIV-infectedpatients were 95.2% (89.9%-100%), 71.7% (59.7%-83.7%), and 62.7% (46.6%-78.8%). Five-year survival for HIV-negative patients was 94.4% (83.8%-100%) (P < 0.001). Multivariate analysis revealed the following variables to be associated with death in HIV-infectedpatients: peritoneal dialysis vs hemodialysis [hazard ratio; (95% CI): 2.88 (1.16-7.17)] and being on effective cART [hazard ratio (95% CI): 0.39 (0.16-0.97)]. CONCLUSIONS: Medium-term survival of HIV-infectedpatients on dialysis was lower than that of matched HIV-negative patients. Fewer HIV-infectedpatients had access to kidney transplantation. Being on effective cART improves survival. Further studies are needed to determine whether peritoneal dialysis increases mortality.
Authors: Jose M Miro; Federico Cofan; Joan C Trullas; Christian Manzardo; Carlos Cervera; Montserrat Tuset; Federico Oppenheimer; Mercedes Brunet; Asuncion Moreno; Josep M Campistol; Jose M Gatell Journal: Curr HIV/AIDS Rep Date: 2012-09 Impact factor: 5.071
Authors: Ayla Cash; Xun Luo; Eric K H Chow; Mary Grace Bowring; Ashton A Shaffer; Brianna Doby; Corey E Wickliffe; Charles Alexander; Deborah McRann; Aaron A R Tobian; Dorry L Segev; Christine M Durand Journal: Clin Transplant Date: 2018-01-16 Impact factor: 2.863
Authors: Sarah E Van Pilsum Rasmussen; Mary Grace Bowring; Ashton A Shaffer; Macey L Henderson; Allan Massie; Aaron A R Tobian; Dorry L Segev; Christine M Durand Journal: Clin Transplant Date: 2018-08-31 Impact factor: 2.863