Details:

Alternative Title:
Antivir Ther
Publisher's site:
http://dx.doi.org/10.3851/IMP1766
Personal Author:
Wyatt, Christina M. ; Hoover, Donald R. ; Shi, Qiuhu ; Tien, Phyllis C. ; Karim, Roksana ; ... More +
Wyatt, Christina M. ; Hoover, Donald R. ; Shi, Qiuhu ; Tien, Phyllis C. ; Karim, Roksana ; Cohen, Mardge H. ; Goderre, Johanna L. ; Seaberg, Eric C. ; Lazar, Jason ; Young, Mary A. ; Klotman, Paul E. ; Anastos, Kathryn Less -
Description:
Background

We previously reported an increased risk of all-cause and AIDS mortality among HIV-infected women with albuminuria (proteinuria or microalbuminuria) enrolled in the Women’s Interagency HIV Study (WIHS) prior to the introduction of highly active antiretroviral therapy (HAART).

Methods

The current analysis includes 1,073 WIHS participants who subsequently initiated HAART. Urinalysis for proteinuria and semi-quantitative testing for microalbuminuria from two consecutive study visits prior to HAART initiation were categorized as follows: confirmed proteinuria (both specimens positive for protein), confirmed microalbuminuria (both specimens positive with at least one microalbuminuria), unconfirmed albuminuria (one specimen positive for proteinuria or microalbuminuria), or negative (both specimens negative). Time from HAART initiation to death was modeled using proportional hazards analysis.

Results

Compared to the reference group of women with two negative specimens, the hazard ratio (HR) for all-cause mortality was significantly elevated for women with confirmed microalbuminuria (HR 1.9; 95% CI 1.2–2.9). Confirmed microalbuminuria was also independently associated with AIDS death (HR 2.3; 95% CI 1.3–4.3), while women with confirmed proteinuria were at increased risk for non-AIDS death (HR 2.4; 95% CI 1.2–4.6).

Conclusions

In women initiating HAART, pre-existing microalbuminuria independently predicted increased AIDS mortality, while pre-existing proteinuria predicted increased risk of non-AIDS death. Urine testing may identify HIV-infected individuals at increased risk for mortality even after the initiation of HAART. Future studies should consider whether these widely available tests can identify individuals who would benefit from more aggressive management of HIV infection and comorbid conditions associated with mortality in this population.


Subject:
[+]
Acquired Immunodeficiency Syndrome
Adult
Albuminuria
Antiretroviral Therapy, Highly Active
Female
Humans
Middle Aged
Predictive Value Of Tests
Proportional Hazards Models
Proteinuria
Risk Factors
Survival Analysis

Source:
Antivir Ther. 16(4):591-596.
Pubmed ID:
21685547
Pubmed Central ID:
PMC3119869
Document Type:
Journal Article
Funding:
K23 DK077568/DK/NIDDK NIH HHS/United States ; K23 DK077568-05/DK/NIDDK NIH HHS/United States ; K23-AI-66943/AI/NIAID NIH HHS/United States ; K23-DK-077568/DK/NIDDK NIH HHS/United States ; UL1 RR024131/RR/NCRR NIH HHS/United States ; ... More +
K23 DK077568/DK/NIDDK NIH HHS/United States ; K23 DK077568-05/DK/NIDDK NIH HHS/United States ; K23-AI-66943/AI/NIAID NIH HHS/United States ; K23-DK-077568/DK/NIDDK NIH HHS/United States ; UL1 RR024131/RR/NCRR NIH HHS/United States ; UO1-AI-31834/AI/NIAID NIH HHS/United States ; UO1-AI-34989/AI/NIAID NIH HHS/United States ; UO1-AI-34993/AI/NIAID NIH HHS/United States ; UO1-AI-34994/AI/NIAID NIH HHS/United States ; UO1-AI-35004/AI/NIAID NIH HHS/United States ; UO1-AI-42590/AI/NIAID NIH HHS/United States ; UO1-HK-32632/HK/PHITPO CDC HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:8c9a644813d4139eec400efd3a8c1b4ff85984c3ba7852de07702c4fb2838e29
File Type:

Supporting Files

• 	nihms280919.nxml	txt
  	nihms280919f1.gif	gif
  	nihms280919f1.jpg	jpeg

More +