• HIV
• Immunocompromised host
• Pneumonia
• Sequelae
• Tuberculosis

• Humans
• Immunocompromised Host
• Pneumonia/complications
• Pneumonia/immunology
• HIV Infections/complications
• HIV Infections/immunology
• Opportunistic Infections/complications

• K23 HL164289 NHLBI NIH HHS

• HIV/AIDS
• albumin creatinine ratio
• chronic kidney disease
• cystatin C
• estimated glomerular filtration rate
• serum creatinine

• HIV
• associated factors
• chronic kidney disease
• experienced
• highly active antiretroviral therapy
• naïve
• prevalence

• HIV
• Romania
• drug
• immunosuppression
• interaction
• kidney transplantation

• Humans
• Kidney Transplantation
• Female
• Adult
• HIV Infections/complications
• HIV Infections/drug therapy
• Kidney Failure, Chronic/surgery
• Kidney Failure, Chronic/complications
• Romania
• Immunosuppressive Agents/therapeutic use
• Immunosuppressive Agents/adverse effects
• Tacrolimus/therapeutic use
• Drug Interactions

• people with HIV (PWH)
• renal safety
• tenofovir alafenamide (TAF)

• Humans
• Tenofovir/adverse effects
• Tenofovir/therapeutic use
• Tenofovir/analogs & derivatives
• HIV Infections/drug therapy
• Alanine/adverse effects
• Alanine/therapeutic use
• Alanine/analogs & derivatives
• Adenine/analogs & derivatives
• Adenine/adverse effects
• Adenine/therapeutic use
• Anti-HIV Agents/adverse effects
• Anti-HIV Agents/therapeutic use
• Kidney/drug effects

• Acquired immunodeficiency syndrome
• HIV
• India
• diabetes mellitus
• dyslipidemia
• heart disease risk factors
• hypertension

• Central and Eastern Europe
• HIV
• chronic kidney disease

• Cross-Sectional Studies
• Europe/epidemiology
• Europe, Eastern/epidemiology
• HIV Infections/prevention & control
• HIV Infections/therapy
• Humans
• Nephrology
• Renal Insufficiency, Chronic/epidemiology
• Renal Insufficiency, Chronic/therapy

• HIV infection
• antiretroviral therapy
• chronic kidney disease
• tenofovir disoproxil fumarate

• APOL1
• HIV
• Kidney disease
• Microalbuminuria
• Nigeria

• Adult
• Albuminuria/epidemiology
• Albuminuria/etiology
• Apolipoprotein L1
• Coinfection
• Diabetes Mellitus, Type 2
• HIV Infections/complications
• HIV Infections/drug therapy
• Humans
• Hypertension/complications
• Hypertension/epidemiology
• Kidney Diseases
• Nigeria/epidemiology
• Sodium-Glucose Transporter 2 Inhibitors/therapeutic use

• R01 DK127912 NIDDK NIH HHS
• 75N91019D00024 NCI NIH HHS
• DK127912 NIDDK NIH HHS
• D43 TW011544 FIC NIH HHS
• K08 AI121422 NIAID NIH HHS
• National Institute of Diabetes and Digestive and Kidney Diseases
• Division of Cancer Epidemiology and Genetics, National Cancer Institute

• Female
• Humans
• Middle Aged
• Male
• HIV
• Tenofovir/adverse effects
• Prospective Studies
• Botswana/epidemiology
• Cross-Sectional Studies
• Diabetes Mellitus/diagnosis
• Diabetes Mellitus/drug therapy
• Diabetes Mellitus/epidemiology
• Albuminuria/diagnosis
• Albuminuria/epidemiology
• Albuminuria/complications
• Prevalence
• HIV Infections/diagnosis
• HIV Infections/drug therapy
• HIV Infections/epidemiology

• Antiretroviral
• Dyslipidemia
• HIV/Aids
• Non-AIDS comorbidities

• ART
• HIV positive
• Mettu
• renal impairment

• Jimma University

To evaluate the prevalence and associated factors of abnormal renal function among Ethiopian HIV-infected patients at baseline prior to initiation of antiretroviral therapy (ART) and during follow-up.

We conducted a retrospective observational cohort study of HIV infected patients who initiated ART at the outpatient ART clinic of Mehal Meda Hospital of North Shewa, Ethiopia from January 2012 to August 2018. Demographic and clinical data were abstracted from the medical records of patients. Renal function was assessed by estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease (MDRD) equation. Univariate and multivariate analysis were conducted to determine the factors associated with abnormal renal function at baseline and during follow-up.

Among 353 patients, 70 (19.8%) had baseline eGFR <60 ml/min/1.73m² and 102 (28.9%) had eGFR = 60–89.9 ml/min/1.73m². Factors associated with baseline renal impairment (eGFR <60 ml/min/1.73m²) included female sex (AOR = 3.52, CI 1.75–7.09), CD4 count < 200 cells/mm³ (AOR = 2.75, CI 1.40–5.42), BMI < 25 Kg/m² (AOR = 3.04, CI 1.15–8.92), low hemoglobin (AOR = 2.19, CI 1.16–4.09) and high total cholesterol (AOR = 3.15, CI 1.68–5.92). After a median of 3.0 years of ART, the mean eGFR declined from 112.9 ± 81.2 ml/min/1.73m² at baseline to 93.9 ± 60.6 ml/min/1.73m² (P < 0.001). The prevalence of renal impairment increased from 19.8% at baseline to 22.1% during follow-up. Of 181 patients with baseline normal renal function, 49.7% experienced some degree of renal impairment. Older age (AOR = 3.85, 95% CI 2.03–7.31), female sex (AOR = 4.18, 95% CI 2.08–8.40), low baseline CD4 (AOR = 2.41, 95% CI 1.24–4.69), low current CD4 count (AOR = 2.32, 95% CI 1.15–4.68), high BMI (AOR = 2.91, 95% CI 1.49–5.71), and low hemoglobin (AOR = 3.38, 95% CI 2.00–7.46) were the factors associated with renal impairment during follow-up.

Impaired renal function was common in HIV-infected patients initiating ART in an outpatient setting in Ethiopia, and there appears to be a high prevalence of renal impairment after a median ART follow-up of 3 years. There is a need for assessment of renal function at baseline before ART initiation and regular monitoring of renal function for patients with HIV during follow-up.

• Adolescent
• Adult
• Anti-HIV Agents/therapeutic use
• Cohort Studies
• Ethiopia
• Female
• Follow-Up Studies
• HIV Infections/drug therapy
• HIV Infections/physiopathology
• Humans
• Kidney/physiopathology
• Male
• Middle Aged
• Outpatients/statistics & numerical data
• Retrospective Studies
• Young Adult

• HIV
• chronic kidney disease (CKD)
• osteoporotic fractures
• tenofovir disoproxil fumarate (TDF)
• veteran affairs informatics and computing infrastructure

• Adult
• Aged
• Anti-HIV Agents/adverse effects
• Cohort Studies
• Female
• HIV Infections/drug therapy
• Humans
• Logistic Models
• Male
• Middle Aged
• Osteoporotic Fractures/chemically induced
• Osteoporotic Fractures/epidemiology
• Renal Insufficiency, Chronic/chemically induced
• Renal Insufficiency, Chronic/epidemiology
• Tenofovir/adverse effects
• Veterans

• Comorbidities
• Economic evaluation
• HIV/HCV
• HIV + 
• Management

• Gilead Sciences

• HIV infection
• clinical research/practice
• end-stage renal disease
• infection and infectious agents - viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)
• infectious disease
• kidney transplantation
• kidney transplantation/nephrology
• organ allocation
• organ procurement and allocation
• panel reactive antibody (PRA)
• renal replacement therapy
• waiting list

• HIV
• comorbidities
• estimated glomerular filtration rate
• kidney disease
• renal impairment

• estimated glomerular filtration rate
• creatinine
• dual regimen
• kidney
• renal transporters

• Cameroon
• Chronic kidney disease
• Douala
• Human immune deficiency virus

• Adult
• Cameroon
• Female
• HIV Infections/complications
• Humans
• Male
• Middle Aged
• Renal Insufficiency, Chronic/complications
• Renal Insufficiency, Chronic/epidemiology
• Renal Insufficiency, Chronic/therapy
• Retrospective Studies
• Treatment Outcome

• HIV
• ageing
• antiretroviral therapy
• cardiovascular risk factors
• non-communicable diseases
• sub-Saharan Africa

• Adult
• Africa South of the Sahara/epidemiology
• Delivery of Health Care
• Female
• HIV Infections/drug therapy
• HIV Infections/epidemiology
• Humans
• Hypertension/complications
• Male
• Middle Aged
• Noncommunicable Diseases/epidemiology
• Obesity/epidemiology
• Prevalence
• Retrospective Studies

Background: The burden of the people living with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) is largely borne by communities in Sub-Saharan Africa. The rate of kidney disease is increasing amongst HIV patients and occurs more often in patients with advanced stage of the disease with lower CD₄ counts and associated with a high rate of morbidity and mortality. The objective of this study is to determine the prevalence and predictors of chronic kidney disease (CKD) amongst HIV patients on highly active antiretroviral therapy (HAART) at the University of Calabar Teaching Hospital, Calabar.

Materials and methods: This was a cross-sectional study that was carried out over a 4-month period from May to August 2018. In all, a total of 118 patients with HIV on HAART were recruited into the study in a consecutive manner and their serum creatinine measured with the calculation of estimated glomerular filtration rate (eGFR). Other data collected were sex, age, weight, height, body mass index (BMI), waist hip ratio (WHR), packed cell volume, CD4 count etcetera. Data collected were inputted and analyzed with SPSS version 18, and statistical significance was taken to be p<0.05.

Results: There were more females (69.5%) amongst the HIV participants and the prevalence of CKD was 15.3%. The risk factors seen to be associated with CKD were lower levels of CD4 count below 200 cells/µl, lower PCV, weight, BMI, and eGFR. Also, higher levels of WHR and creatinine were associated with CKD. Factors directly correlated with CKD were weight, BMI and CD4 count levels, while creatinine level was inversely correlated with CKD. However, a logistic regression model showed only creatinine to be a predictor of CKD.

Conclusion: HIV patients on antiretroviral therapy, mainly the highly active antiretroviral therapy (HAART) have a relatively high prevalence of CKD of 15.3% and high level of serum creatinine was predictive of CKD in the logistic regression model in our study.

• HIV
• Nigeria
• South – South
• chronic kidney disease
• predictors

Renal involvement in HIV patients is relatively common and quite broad. However, despite an increasingly large number of HIV patients in Asia, systematic studies of renal involvement are lacking.

The study was carried out to delineate the clinical spectrum of renal disease in HIV/AIDS patients hospitalised in a tertiary care centre.

A total of 510 consecutive hospitalised HIV/AIDS with age >18years were included in the study. Detailed demographic, clinical and laboratory data including urinalysis was obtained from all participants.

Electrolyte disorders were seen in 71% of patients, with the most frequent being hyponatremia (61%). Acute renal failure was seen in 15.8% and CKD was found in 13% of HIV patients. Dipstick proteinuria of grade ≥1+ was seen in 147 patients (29% of total). CD4 count had a significant positive correlation with creatinine clearance, hyponatremia and total leukocyte count, and significant negative correlation with duration of disease and proteinuria.

Electrolyte disorders and renal involvement are quite common in HIV/AIDS patients from India. Prompt diagnosis and management is required as their presence carry higher morbidity and mortality.

• Acute renal failure
• CD4 count
• chronic kidney disease
• electrolyte disorders
• proteinuria

Chronic kidney disease (CKD) has become epidemic in HIV/AIDS patients across Western and Eastern countries. HIV-associated nephropathy (HIVAN) has been consistently reported in studies from North America, Europe and African countries. However, studies from Asian countries are very sparse and differ strikingly in histological spectrum of renal disease, particularly in presence of HIVAN.

The study was carried out to in a teaching hospital from India to delineate the histological spectrum of renal disease and detect presence HIVAN in those with significant proteinuria (≥1gm/day).

Urine analysis was done in 510 consecutive hospitalised HIV/AIDS patients after screening 640 such patients with age >18years. Patients with dipstick proteinuria ≥1+ were subjected to 24-hour urinary protein estimation. Renal biopsy was done in 10 patients with proteinuria ≥1gm/day.

Dipstick proteinuria ≥1+ was present in 29% patients. In patients undergoing kidney biopsy, the most frequent glomerular lesion was mesangial proliferative glomerulonephritis (30%) followed by HIVAN (20%). Tubulo-interstitial lesions were seen in 60% of biopsies. Pooled analysis of all the available kidney biopsy series from India revealed prevalence of HIVAN to be 16.5%.

Contrary to the popular belief, HIVAN appears to be a common entity in this part of world too. High degree of clinical suspicion is required as diagnosis of HIVAN caries higher morbidity and mortality. Moreover, an early diagnosis and timely management can improve prognosis in such patients.

• Glomerular lesion
• HIVAN
• histopathology
• kidney biopsy
• renal biopsy

• Botswana
• Diabetes mellitus
• chronic kidney disease
• glomerular filtration rate

• Adult
• Aged
• Aged, 80 and over
• Botswana
• Comorbidity
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2/blood
• Diabetes Mellitus, Type 2/epidemiology
• Female
• Glomerular Filtration Rate
• Humans
• Inpatients/statistics & numerical data
• Logistic Models
• Male
• Middle Aged
• Prevalence
• Renal Insufficiency, Chronic/blood
• Renal Insufficiency, Chronic/epidemiology
• Risk Factors
• Severity of Illness Index
• Young Adult

• Chronic kidney disease
• HIV
• Intravenous drug use
• Methadone

Combined Antiretroviral therapy (cART) has improved life-expectancy of people living with HIV (PLHIV) but as they age, prevalence of chronic non-AIDS related comorbidities may increase. We study the evolution of HIV-disease markers and comorbidities’ prevalence in PLHIV in Greece. Two cross-sectional analyses (2003 and 2013) on data from the AMACS cohort were performed. Comparisons were based on population average models and were repeated for subjects under follow-up at both 2003 and 2013. 2,403 PLHIV were identified in 2003 and 4,910 in 2013 (1,730 contributing for both cross-sections). Individuals in 2013 were on average older, diagnosed/treated for HIV for longer, more likely to be on cART, virologically suppressed, and with higher CD4 counts. Chronic kidney disease, dyslipidemia and hypertension prevalence increased over time. There was an increase in prescription of lipid-lowering treatment (3.5% in 2003 vs. 7.7% 2013, p<0.001). Among 220 and 879 individuals eligible for Framingham 10-year Event Risk calculation, the proportion of patients in the high-risk group (>20%) increased from 18.2% to 22.2% (p = 0.002). Increase in the prevalence of comorbidities was more pronounced in the subset of patients who were followed in both 2003 and 2013. The increased availability and uptake of cART led to significant improvements in the immuno-virological status of PLHIV in Greece, but they aged alongside an increase in prevalence of non-AIDS related comorbidities. These results highlight the need for appropriate monitoring, optimal cART selection and long-term management and prevention strategies for such comorbidities.

• Acquired immune deficiency syndrome
• Dental management
• Human immunodeficiency virus
• Oral manifestations
• Treatment planning considerations

In people living with HIV, much is known about chronic kidney disease, defined as a glomerular filtration rate under 60 mL/min. However, there is scarce data about prevalence and risk factors for milder impairment (60–89 mL/min).

The present study aims to assess the influence of sex, antiretroviral therapy, and classical risk factors on the occurrence of mild decreased renal function in a large Spanish cohort of HIV-infected patients.

Cross-sectional, single center study, including all adult HIV-1-infected patients under antiretroviral treatment with at least two serum creatinine measures during 2014, describing the occurrence of and the risk factors for mildly decreased renal function (eGFR by CKD-EPI creatinine equation of 60–89 mL/min).

Among the 4337 patients included, the prevalence rate of mildly reduced renal function was 25%. Independent risk factors for this outcome were age older than 50 years (OR 3.03, 95% CI 2.58–3.55), female sex (OR 1.23, 95% CI 1.02–1.48), baseline hypertension (OR 1.57, 95% CI 1.25–1.97) or dyslipidemia (OR 1.48, 95% CI 1.17–1.87), virologic suppression (OR 1.88, 95% CI 1.39–2.53), and exposure to tenofovir disoproxil-fumarate (OR 1.67, 95% CI 1.33–2.08) or ritonavir-boosted protease-inhibitors (OR 1.19, 95% CI 1.03–1.39).

Females and patients over 50 seem to be more vulnerable to renal impairment. Potentially modifiable risk factors and exposure to tenofovir disoproxil-fumarate or ritonavir-boosted protease-inhibitors are present even in earlier stages of chronic kidney dysfunction. It remains to be determined whether early interventions including antiretroviral therapy changes (tenofovir alafenamide, cobicistat) or improving comorbidities management will improve the course of chronic kidney disease.

• Antiretroviral drugs
• Chronic kidney disease
• Glomerular filtration rate estimates
• HIV-infection

• HIV
• chronic kidney disease
• comorbid conditions
• systematic review

• Anti-HIV Agents/therapeutic use
• Diabetes Mellitus/epidemiology
• HIV Infections/complications
• HIV Infections/drug therapy
• Humans
• Hypertension/epidemiology
• Prevalence
• Renal Insufficiency, Chronic/complications
• Renal Insufficiency, Chronic/diagnosis
• Renal Insufficiency, Chronic/epidemiology

• P30 NR015335 NINR NIH HHS

• Autopsy
• Chronic kidney disease
• Combination antiretroviral therapy
• Human immune deficiency virus
• Renal biopsy

• Adult
• Aged
• Antiretroviral Therapy, Highly Active
• Asian People
• Autopsy
• Biopsy
• Female
• HIV Infections/pathology
• Humans
• Japan
• Kidney/pathology
• Kidney Function Tests
• Male
• Middle Aged
• Renal Insufficiency, Chronic/pathology
• Retrospective Studies

• Human immunodeficiency virus
• Prevalence
• Renal insufficiency
• Risk factors

• Korea Centers for Disease Control & Prevention

• Antiretroviral therapy
• Estimated glomerular filtration rate
• Human immunodeficiency virus
• Proteinuria
• Tenofovir

Accurately determining renal function is essential for clinical management of HIV patients. Classically, it has been evaluated by estimating glomerular filtration rate (eGFR) with the MDRD-equation, but today there is evidence that the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has greater diagnostic accuracy. To date, however, little information exists on patients with HIV-infection. This study aimed to evaluate eGFR by CKD-EPI vs. MDRD equations and to stratify renal function according to KDIGO guidelines.

Cross-sectional, single center study including adult patients with HIV-infection.

Four thousand five hundred three patients with HIV-infection (864 women; 19%) were examined. Median age was 45 years (IQR 37–52), and median baseline creatinine was 0.93 mg/dL (IQR 0.82–1.05). A similar distribution of absolute measures of eGFR was found using both formulas (p = 0.548). Baseline median eGFR was 95.2 and 90.4 mL/min/1.73 m² for CKD-EPI and MDRD equations (p < 0.001), respectively. Of the 4503 measurements, 4109 (91.2%) agreed, with a kappa index of 0.803. MDRD classified 7.3% of patients as “mild reduced GFR” who were classified as “normal function” with CKD-EPI. Using CKD-EPI, it was possible to identify “normal function” (>90 mL/min/1.73 m²) in 73% patients and “mild reduced GFR” (60–89 mL/min/1.73 m²) in 24.3% of the patients, formerly classified as >60 mL/min/1.73 m² with MDRD.

There was good correlation between CKD-EPI and MDRD. Estimating renal function using CKD-EPI equation allowed better staging of renal function and should be considered the method of choice. CKD-EPI identified a significant proportion of patients (24%) with mild reduced GFR (60–89 mL/min/1.73 m²).

• Chronic kidney disease
• Glomerular filtration rate estimates
• HIV-infection

Human immunodeficiency virus (HIV) infection can cause a broad spectrum of renal diseases. However, there is paucity of Indian data on the patterns of renal lesions in HIV-seropositive patients. The aim of the present study was to delineate the spectrum of renal lesions in HIV/acquired immunodeficiency syndrome patients. In this prospective study, all HIV-positive patients of both genders aged >18 years were screened for renal disease. Patients with proteinuria of more than 1 g/24 h were subjected to renal biopsy. A total of 293 HIV-positive patients were screened; of these, 136 (46.4%) patients found to have renal involvement. Dipstick-positive proteinuria of 1+ or more was observed in 112 (38.2%) patients, and 16 (14.2%) patients had proteinuria of more than 1 g/24 h. Renal biopsy in 14 cases revealed glomerulonephritis (GN) in 12 (85.7%) (isolated GN in 4 [28.5%] and GN mixed with chronic TIN in 8 [57.1%]) patients. These include mesangioproliferative GN in 5 (35.7%), membranoproliferative GN in 2 (14.2%), focal segmental glomerulosclerosis in 2 (14.2%), diffuse proliferative GN in 2 (14.2%), and diabetic nephropathy in 1 (7.1%) patients. Chronic interstitial nephritis was noted in 10 (71.42%) (superimposed on GN in 8 [57.1%], isolated in 2 [14.2%]) patients. Granulomatous interstitial nephritis was seen in 3 (24.1%) cases. GN and chronic interstitial nephritis were noted in 85.7% and 71.42% of patients, respectively, mostly superimposed on each other. Mesangioproliferative GN was the most common glomerular lesion, but classical HIV-associated nephropathy was not observed.

• HIV infection
• HIV-associated nephropathy
• nephropathies
• proteinuria

Kidney diseases in human immunodeficiency virus (HIV)-infected patients are often misdiagnosed. Despite reductions in morbidity and mortality owing to widespread use of highly effective combination antiretroviral therapy (cART), acute kidney injury (AKI) and chronic kidney disease (CKD) are still more common in these patients than in the general population, and are associated with poor health outcomes. HIV-associated nephropathy and HIV immune complex kidney diseases are the more recognizable HIV-related kidney diseases. However, a broad spectrum of kidney disorders related or not directly related with HIV infection can be observed, including cART-induced AKI, CKD, proximal tubular dysfunction, crystalluria and urolithiasis, among others. This review summarizes the major epidemiologic studies of kidney diseases in HIV-infected patients, discusses novel approaches that may potentially limit nephrotoxicity such as the use of tenofovir alafenamide, and outlines current screening measures for early diagnosis of kidney dysfunction or tubular damage, and for accurate detection of increased risk for acute or chronic kidney diseases.

• HIV
• acute kidney injury
• antiretroviral
• chronic kidney disease
• nephropathy

The prevalence of HIV-associated chronic kidney disease (CKD) varies geographically and depends on the definition of CKD used, ranging from 4.7% to 38% globally. The incidence, however, has decreased with the use of effective combined antiretroviral therapy (cART). A wide variety of histological patterns are seen in HIV-associated kidney diseases that include glomerular and tubulointerstitial pathology. In resource-rich settings, there has been a plateau in the incidence of end-stage renal disease secondary to HIV-associated nephropathy (HIVAN). However, the prevalence of end-stage renal disease in HIV-positive individuals has risen, mainly due to increased longevity on cART. There is a disparity in the occurrence of HIVAN among HIV-positive individuals such that there is an 18- to 50-fold increased risk of developing kidney disease among HIV-positive individuals of African descent aged between 20 and 64 years and who have a poorer prognosis compared with their European descent counterparts, suggesting that genetic factors play a vital role. Other risk factors include male sex, low CD4 counts, and high viral load. Improvement in renal function has been observed after initiation of cART in patients with HIV-associated CKD. Treatment with an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker is recommended, when clinically indicated in patients with confirmed or suspected HIVAN or clinically significant albuminuria. Other standard management approaches for patients with CKD are recommended. These include addressing other cardiovascular risk factors (appropriate use of statins and aspirin, weight loss, cessation of smoking), avoidance of nephrotoxins, and management of serum bicarbonate and uric acid, anemia, calcium, and phosphate abnormalities. Early diagnosis of kidney disease by screening of HIV-positive individuals for the presence of kidney disease is critical for the optimal management of these patients. Screening for the presence of kidney disease upon detection of HIV infection and annually thereafter in high-risk populations is recommended.

• HIV infection
• chronic kidney disease
• current management

• Adult
• Anti-HIV Agents/adverse effects
• Anti-HIV Agents/therapeutic use
• Creatinine/blood
• Databases, Factual
• Female
• Glomerular Filtration Rate
• HIV Infections/drug therapy
• Humans
• Kidney/drug effects
• Kidney/physiopathology
• Kidney Diseases/chemically induced
• Male
• Middle Aged
• Poisson Distribution
• Proportional Hazards Models
• Prospective Studies
• Risk Factors
• Tenofovir/adverse effects
• Tenofovir/therapeutic use

• U01 AI069907 NIAID NIH HHS
• Foundation for the National Institutes of Health
• National Institute of Child Health and Human Development
• National Cancer Institute
• The Dutch Ministry of Foreign Affairs
• Hong Kong Council for AIDS Trust Fund
• ViiV Healthcare
• The Australian Government Department of Health and Ageing

Supplemental Digital Content is available in the text

To examine the association between injection cocaine use, hepatitis C virus (HCV) infection, and chronic renal impairment (CRI).

Prospective observational cohort study of HIV–HCV coinfected patients.

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 m². 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.

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.

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.

• Adult
• Anti-HIV Agents/administration & dosage
• Anti-HIV Agents/adverse effects
• Anti-HIV Agents/therapeutic use
• CD4 Lymphocyte Count
• Comorbidity
• Dideoxynucleosides/therapeutic use
• Drug Therapy, Combination
• Emtricitabine/therapeutic use
• Female
• Glomerular Filtration Rate/drug effects
• HIV Infections/drug therapy
• HIV Protease Inhibitors/administration & dosage
• HIV Protease Inhibitors/adverse effects
• HIV Protease Inhibitors/therapeutic use
• Humans
• Lamivudine/therapeutic use
• Lopinavir/therapeutic use
• Male
• Middle Aged
• Retrospective Studies
• Reverse Transcriptase Inhibitors/administration & dosage
• Reverse Transcriptase Inhibitors/adverse effects
• Reverse Transcriptase Inhibitors/therapeutic use
• Ritonavir/therapeutic use
• Tenofovir
• Viral Load

• HIV
• aging
• cardiovascular disease
• frailty
• polypharmacy