The Impact of Hepatitis C Coinfection on Kidney Disease Related to Human Immunodeficiency Virus (HIV): A Biopsy Study

摘要

Approximately 1 in 4 individuals infected with the human immunodeficiency virus (HIV) in the United States is coinfected with the hepatitis C virus. Both conditions increase the risk for the development and progression of kidney disease. The effect, however, of coexisting HIV and hepatitis C infection on the spectrum and progression of kidney disease is not well known. To compare the clinical features, histopathologic kidney diagnoses, and proportion of individuals progressing to end-stage kidney disease (ESKD), we reviewed the clinical records of HIV-infected individuals with and without hepatitis C coinfection who underwent ultrasound-guided percutaneous kidney biopsies between February 7, 1995, and March 30, 2009. Of the 249 HIV-infected individuals included in this study, 58% were coinfected with hepatitis C. Coinfected individuals were older (mean age, 46 ± 7 vs. 44 ± 10 yr, respectively; p The current study demonstrates that coinfection with hepatitis C in individuals infected with HIV predisposes these individuals to immune-complex glomerulonephritides and is associated with increased risk of ESKD in the biopsied population. Abbreviations: CI = confidence interval, eGFR = estimated glomerular filtration rate, ESKD = end-stage kidney disease, HAART = highly active antiretroviral therapy, HIV = human immunodeficiency virus, HIVAN = HIV-associated nephropathy, HR = hazard ratio, ICGN = immune complex glomerulonephritis, MPGN = membranoproliferative glomerulonephritis.