Frank J Palella1, Xiuhong Li2, Samir K Gupta3, Michelle M Estrella4, John P Phair1, Joseph B Margolick2, Roger Detels5, Lawrence Kingsley6, Lisa P Jacobson2. 1. Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. 2. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 3. Indiana University School of Medicine, Indianapolis, Indiana. 4. Division of Nephrology, University of California San Francisco School of Medicine, San Francisco. 5. University of California Los Angeles School of Public Health, Los Angeles, California. 6. University of Pittsburgh Graduate School of Public Health, Pitts burgh, Pennsylvania, USA.
Abstract
BACKGROUND: Factors affecting kidney function and proteinuria among HIV-positive (HIV+) and HIV-negative (HIV-) persons need better characterization. METHODS: We evaluated estimated glomerular filtration rate (eGFR, ml/min per 1.73 m) changes, proteinuria prevalence (a urine protein-to-creatinine ratio of ≥0.2 at two consecutive visits) and associated factors among HIV+ and HIV- men. RESULTS: There were 917 HIV+ men receiving HAART, 159 HIV+ men not receiving HAART, and 1305 HIV- men seen from October 2003 to September 2014. Median annual eGFR change was -0.5, -0.8% for HIV+ and -0.3% for HIV- men (P < 0.001). Factors significantly (P < 0.05) associated with more than 3% annual eGFR decline were HAART receipt (but no specific antiretroviral drug), age more than 50, hypertension, diabetes, current smoking. Proteinuria existed in 14.9% of visit-pairs among HAART recipients, 5.8% among non-HAART recipients, and 1.9% among HIV- men, and was associated with subsequent annual more than 3% eGFR decline (odds ratio 1.80, P < 0.001). Proteinuria-associated factors also included HAART use (vs. HIV-), age at least 50 (vs. <40), diabetes, hypertension, current smoking, hepatitis C virus-infection (all P < 0.05) and, among HIV+ men, lower CD4 cell count, didanosine, saquinavir, or nelfinavir use (all P < 0.05). After adjusting for proteinuria, among HAART users, having a detectable HIV RNA, cumulative use of tenofovir disoproxil fumarate, emtricitabine, ritonavir, atazanavir, any protease inhibitor, or fluconazole were associated with more than 3% annual eGFR decline. CONCLUSION: Longitudinal kidney function decline was associated with HAART use but no individual antiretroviral drug, and traditional kidney disease risks. Proteinuria was nearly seven times more common in HAART-treated men than HIV- men, reflected recent eGFR decline and predicted subsequent eGFR decline.
BACKGROUND: Factors affecting kidney function and proteinuria among HIV-positive (HIV+) and HIV-negative (HIV-) persons need better characterization. METHODS: We evaluated estimated glomerular filtration rate (eGFR, ml/min per 1.73 m) changes, proteinuria prevalence (a urine protein-to-creatinine ratio of ≥0.2 at two consecutive visits) and associated factors among HIV+ and HIV- men. RESULTS: There were 917 HIV+ men receiving HAART, 159 HIV+ men not receiving HAART, and 1305 HIV- men seen from October 2003 to September 2014. Median annual eGFR change was -0.5, -0.8% for HIV+ and -0.3% for HIV- men (P < 0.001). Factors significantly (P < 0.05) associated with more than 3% annual eGFR decline were HAART receipt (but no specific antiretroviral drug), age more than 50, hypertension, diabetes, current smoking. Proteinuria existed in 14.9% of visit-pairs among HAART recipients, 5.8% among non-HAART recipients, and 1.9% among HIV- men, and was associated with subsequent annual more than 3% eGFR decline (odds ratio 1.80, P < 0.001). Proteinuria-associated factors also included HAART use (vs. HIV-), age at least 50 (vs. <40), diabetes, hypertension, current smoking, hepatitis C virus-infection (all P < 0.05) and, among HIV+ men, lower CD4 cell count, didanosine, saquinavir, or nelfinavir use (all P < 0.05). After adjusting for proteinuria, among HAART users, having a detectable HIV RNA, cumulative use of tenofovir disoproxil fumarate, emtricitabine, ritonavir, atazanavir, any protease inhibitor, or fluconazole were associated with more than 3% annual eGFR decline. CONCLUSION:Longitudinal kidney function decline was associated with HAART use but no individual antiretroviral drug, and traditional kidney disease risks. Proteinuria was nearly seven times more common in HAART-treated men than HIV- men, reflected recent eGFR decline and predicted subsequent eGFR decline.
Authors: Anda Gonciulea; Ruibin Wang; Keri N Althoff; Michelle M Estrella; Deborah E Sellmeyer; Frank J Palella; Jordan E Lake; Lawrence A Kingsley; Todd T Brown Journal: J Acquir Immune Defic Syndr Date: 2019-07-01 Impact factor: 3.731
Authors: Anthony N Muiru; Erin Madden; Ani Chilingirian; Anna D Rubinsky; Rebecca Scherzer; Richard Moore; Celia P Corona Villalobos; Jose Manuel Monroy Trujillo; Chirag R Parikh; Chi-Yuan Hsu; Michael G Shlipak; Michelle M Estrella Journal: HIV Med Date: 2021-12-12 Impact factor: 3.094
Authors: Giovanni Sarteschi; Antonio Di Biagio; Emanuele Focà; Lucia Taramasso; Francesca Bovis; Anna Celotti; Michele Mirabella; Laura Magnasco; Sara Mora; Mauro Giacomini; Matteo Bassetti Journal: PLoS One Date: 2020-10-15 Impact factor: 3.240