August 18, 2010

HIV-Positive IV Drug Users Have Higher Risk of Kidney Dysfunction

HIV-positive intravenous drug users (IDUs) are more likely to have kidney dysfunction than IDUs not infected with the virus, according to a study published online August 12 in the Clinical Journal of the American Society of Nephrology.

People with HIV are more likely to have kidney problems than HIV-negative people. This is due, in part, to the fact that many risk factors—such as African-American race, hepatitis C infection and hypertension—are all more common in HIV-positive individuals. Researchers suspect, however, that the higher rates of kidney dysfunction and serious kidney disease among HIV-positive people are also due to effects of HIV infection.

Though IDUs are far more likely to be infected with HIV than non-IV drug users, little is known about how common kidney disease is among IDUs who are HIV positive. To examine this question, Shruti Mehta, PhD, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and her colleagues looked at kidney function in 902 predominantly African-American IDUs from the AIDS Linked to the Intravenous Experience Cohort study.

Of this group, 273 were HIV positive. Mehta and her colleagues looked at the presence of protein in the participants’ urine. When protein is too high, this condition is called proteinuria, and it indicates diminished kidney function.

Mehta found that the incidence of proteinuria was relatively high across the cohort, at nearly 25 percent. Rates were particularly high among the HIV-positive IDUs: 45 percent had proteinuria. This rate was nearly three-fold higher than in the HIV-negative IDUs. Other factors associated with proteinuria were age, health insurance, employment status, hepatitis B and hepatitis C infection, diabetes and high blood pressure. Neither antiretroviral drug experience nor history of illicit drug use was associated with lower kidney function.

“In an aging, predominantly African-American cohort of injection drug users, we found a striking burden of proteinuria that was strongly associated with HIV status,” concluded the authors. “In addition to being a pathway to [end-stage kidney disease], proteinuria is a potent risk factor for cardiovascular morbidity and mortality. Evaluation of aggressive screening and disease-modification strategies in this high-risk population is warranted.”

Search: Kidney, intravenous drug user, IDU, hepatitis C, hepatitis B, proteinuria, Shruti Mehta

Scroll down to comment on this story.

Previous Comments: