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Trends in nephropathy among HIV-infected patients

Susan E Buskin1, Mauro S Torno, Deborah F Talkington

  • 1HIV/AIDS Program, Prevention Division, Public Health-Seattle and King County, Seattle, Washington, USA. susan.buskin@kingcounty.gov

Journal of the National Medical Association
|January 15, 2010
PubMed

Insights

HIV-associated nephropathy (HIVAN) trends and risk factors were studied. Incidence rose then fell, but its presence at death increased, highlighting disparities in Black patients and injection drug users.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Nephropathy significantly complicates HIV infection prognosis.
  • Understanding trends and risk factors for HIV-associated nephropathy (HIVAN) is crucial.

Purpose of the Study:

  • To examine temporal trends in all-cause nephropathy (ACN) within the HIV-infected population.
  • To identify key correlates associated with ACN in HIV patients.

Main Methods:

  • Analysis of the Adult/Adolescent Spectrum of HIV Disease longitudinal observational cohort.
  • Follow-up of patients for a median of 3 years (1990-2003) across 11 US metropolitan areas.

Main Results:

  • ACN incidence increased until the mid-1990s, then decreased.
  • The proportion of patients with ACN at death rose over the study period.
  • Key ACN correlates included Black race, injection drug use (IDU), indinavir use, hypertension, diabetes, low CD4+ count, high viral load, and older age.

Conclusions:

  • HIVAN is a significant health disparity affecting Black individuals and IDUs.
  • These disparities have critical implications for mortality in the HIV-infected population.
Abstract

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