HIV+ dialysis patients: Differential survival by race compared with HIV/HCV coinfection

March 21, 2018|Infectious Disease Practitioner

FROM KIDNEY INTERNATIONAL

Race, but not coinfection with hepatitis C virus, differentially affects survival of HIV-positive patients who have end-stage renal disease, according to a study published in Kidney International.

Nonwhites fared significantly worse in survival than did the white cohort when both groups were infected with HIV alone, but the two groups fared similarly badly when coinfected with HIV and HCV, according to Deirdre L. Sawinski, MD, assistant professor at the University of Pennsylvania, Philadelphia, and assistant medical director, Penn Kidney Pancreas Transplant Program, and her colleagues.

The investigators retrospectively assessed 410,545 HIV-negative/HCV-negative individuals as reference controls and compared them with 5,348 HIV+ and 1,863 HIV+/HCV+ coinfected individuals from 2,858 dialysis facilities in 47 states, using a database from one of the largest dialysis providers in the country.

They found that HIV infection was not associated with a higher risk of death in white patients (hazard ratio, 1.03), in contrast to HIV/HCV coinfection, which was significantly associated with a higher mortality (HR, 1.48). However, in the nonwhite patients, HIV infection (HR, 1.44) and HIV/HCV coinfection (HR, 1.71) were both significantly associated with increased mortality.