Research Papers

@article{Rossi2016,
title = {Frequent injection cocaine use increases the risk of renal impairment among Hepatitis C and HIV co-infected patients},
author = {Carmine Rossi and Joseph Cox and Curtis Cooper and Valérie Martel-Laferrière and Sharon Walmsley and John Gill and Ruth Sapir-Pichhadze and Erica E. M. Moodie and Marina B. Klein},
url = {https://www.ncbi.nlm.nih.gov/pubmed/26859371},
doi = {10.1097/QAD.0000000000001060},
year = {2016},
date = {2016-06-01},
journal = {AIDS},
abstract = {OBJECTIVE:
To examine the association between injection cocaine use, hepatitis C virus (HCV) infection, and chronic renal impairment (CRI).
DESIGN:
Prospective observational cohort study of HIV-HCV coinfected patients.
METHODS:
Data from 1129 participants in the Canadian Co-Infection Cohort with baseline and follow-up serum creatinine measurements between 2003 and 2014 were analyzed. Prevalent and incident cohorts were created to examine the association between self-reported past, current, and cumulative cocaine use and chronic HCV with CRI. CRI was defined as an estimated glomerular filtration rate below 70 ml/min per 1.73 m. Multivariate logistic regression was used to calculate odds ratios, and discrete-time proportional-hazards models were used to calculate hazard ratios for cocaine use, in the two respective cohorts, adjusted for HCV RNA and important demographic, HIV disease stage, and comorbidity confounders.
RESULTS:
Eighty-seven participants (8%) had prevalent CRI. Past injection cocaine use was associated with a two-fold greater risk of prevalent CRI [odds ratio 2.03, 95% confidence interval (CI) 0.96, 4.32]. During follow-up, 126 of 1061 participants (12%) developed incident CRI (31 per 1000 person-years). Compared to nonusers, heavy (≥ 3 days/week) and frequent injection cocaine users (≥75% of follow-up time) experienced more rapid progression to CRI (hazard ratio 2.65, 95% CI 1.35, 5.21; and hazard ratio 1.82, 95% CI 1.07, 3.07, respectively). There was no association between chronic HCV and CRI in either cohort.
CONCLUSION:
After accounting for HCV RNA, frequent and cumulative injection cocaine abuse was associated with CRI progression and should be taken into consideration when evaluating impaired renal function in HIV-HCV coinfection.},
keywords = {Chronic hepatitis C, Co-infection, Cocaine, HIV, Intravenous substance abuse, Renal insufficiency},
pubstate = {published},
tppubtype = {article}
}