2018 |
C, Rossi; S, Saeed; J, Cox; ML, Vachon; V, Martel-Laferrière; SL, Walmsley; C, Cooper; MJ, Gill; M, Hull; EEM, Moodie; MB, Klein Hepatitis C virus cure does not impact kidney function decline in HIV co-infected patients Journal Article AIDS, 2018. Abstract | Links | BibTeX | Tags: Hepatitis C virus, Kidney function, Sustained virologic response @article{C2018, title = {Hepatitis C virus cure does not impact kidney function decline in HIV co-infected patients}, author = {Rossi C and Saeed S and Cox J and Vachon ML and Martel-Laferrière V and Walmsley SL and Cooper C and Gill MJ and Hull M and Moodie EEM and Klein MB}, url = {https://pubmed.ncbi.nlm.nih.gov/29369156/}, doi = {10.1097/QAD.0000000000001750}, year = {2018}, date = {2018-03-27}, journal = {AIDS}, abstract = {Objective: To examine the impact of sustained virologic response (SVR) and illicit (injection and noninjection) drug use on kidney function among hepatitis C virus (HCV) and HIV co-infected individuals. Design: Longitudinal observational cohort study of HCV-HIV co-infected patients. Methods: Data from 1631 patients enrolled in the Canadian Co-Infection Cohort between 2003 and 2016 were analyzed. Patients who achieved SVR were matched 1 : 2 with chronically infected patients using time-dependent propensity scores. Linear regression with generalized estimating equations was used to model differences in estimated glomerular filtration rates (eGFR) between chronic HCV-infected patients and those achieving SVR. The relationship between illicit drug use and eGFR was explored in patients who achieved SVR. Results: We identified 384 co-infected patients who achieved SVR (53% treated with interferon-free antiviral regimens) and 768 propensity-score matched patients with chronic HCV infection. Most patients were men (78%) and white (87%), with a median age of 51 years (interquartile range: 45-56). During 1767 person-years of follow-up, 4041 eGFR measurements were available for analysis. Annual rates of decline in eGFR were similar between patients with SVR [-1.32 (ml/min per 1.73 m)/year, 95% confidence interval (CI) -1.75 to -0.90] and chronic infection [-1.19 (ml/min per 1.73 m) per year, 95% CI -1.55 to -0.84]. Among SVR patients, recent injection cocaine use was associated with rapid eGFR decline [-2.16 (ml/min per 1.73 m)/year, 95% CI -4.17 to -0.16]. Conclusion: SVR did not reduce the rate of kidney function decline among HCV-HIV co-infected patients. Increased risk of chronic kidney disease in co-infection may not be related to persistent HCV replication but to ongoing injection cocaine use.}, keywords = {Hepatitis C virus, Kidney function, Sustained virologic response}, pubstate = {published}, tppubtype = {article} } Objective: To examine the impact of sustained virologic response (SVR) and illicit (injection and noninjection) drug use on kidney function among hepatitis C virus (HCV) and HIV co-infected individuals. Design: Longitudinal observational cohort study of HCV-HIV co-infected patients. Methods: Data from 1631 patients enrolled in the Canadian Co-Infection Cohort between 2003 and 2016 were analyzed. Patients who achieved SVR were matched 1 : 2 with chronically infected patients using time-dependent propensity scores. Linear regression with generalized estimating equations was used to model differences in estimated glomerular filtration rates (eGFR) between chronic HCV-infected patients and those achieving SVR. The relationship between illicit drug use and eGFR was explored in patients who achieved SVR. Results: We identified 384 co-infected patients who achieved SVR (53% treated with interferon-free antiviral regimens) and 768 propensity-score matched patients with chronic HCV infection. Most patients were men (78%) and white (87%), with a median age of 51 years (interquartile range: 45-56). During 1767 person-years of follow-up, 4041 eGFR measurements were available for analysis. Annual rates of decline in eGFR were similar between patients with SVR [-1.32 (ml/min per 1.73 m)/year, 95% confidence interval (CI) -1.75 to -0.90] and chronic infection [-1.19 (ml/min per 1.73 m) per year, 95% CI -1.55 to -0.84]. Among SVR patients, recent injection cocaine use was associated with rapid eGFR decline [-2.16 (ml/min per 1.73 m)/year, 95% CI -4.17 to -0.16]. Conclusion: SVR did not reduce the rate of kidney function decline among HCV-HIV co-infected patients. Increased risk of chronic kidney disease in co-infection may not be related to persistent HCV replication but to ongoing injection cocaine use. |
Research Papers
2018 |
Hepatitis C virus cure does not impact kidney function decline in HIV co-infected patients Journal Article AIDS, 2018. |