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Comorbidities and their impact on mortality in HCV and HCV-HIV-coinfected persons on dialysis

Adeel A Butt1, Uzma A Khan, Melissa Skanderson

  • 1University of Pittsburgh Medical Center, Pittsburgh, PA 15213

Journal of Clinical Gastroenterology
|November 18, 2008
PubMed

Insights

Comorbidities and survival differ between patients with hepatitis C virus (HCV) and those with HCV-HIV coinfection undergoing dialysis. Understanding these differences is crucial for developing targeted interventions for kidney patients.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C virus (HCV) infection is common among patients on dialysis.
  • HCV-HIV coinfection presents unique challenges in this population.
  • Comorbidities significantly impact survival in patients with chronic kidney disease.

Purpose of the Study:

  • To determine the prevalence of HIV-related comorbidities in HCV-infected and HCV-HIV coinfected patients on dialysis.
  • To assess the impact of these comorbidities on mortality in both groups.

Main Methods:

  • Utilized the United States Renal Data System (USRDS) to identify patients with HCV and HCV-HIV coinfection.
  • Employed ICD-9 codes to diagnose medical and psychiatric comorbidities.
  • Applied logistic regression to analyze odds of comorbidities and predictors of mortality.

Main Results:

  • Identified 5310 HCV-infected and 427 HCV-HIV coinfected subjects.
  • HCV-HIV coinfected patients were younger, more likely male, Black, and had lower BMI.
  • Coronary artery disease and diabetes were less common in HCV-HIV coinfected patients, while hepatitis B, wasting, and substance abuse were more frequent. Cirrhosis, wasting, and smoking predicted mortality in HCV-HIV coinfected patients, unlike HCV monoinfected patients.

Conclusions:

  • Comorbidity patterns and mortality predictors differ significantly between HCV-monoinfected and HCV-HIV-coinfected dialysis patients.
  • These distinct profiles necessitate tailored interventions for each group.
  • Clinical management strategies should consider the specific comorbidity burden and survival factors in coinfected individuals.
Abstract

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