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How many times have you started to have a conversation with someone about Hepatitis C only to have it blow up in your face? Have you ever heard someone say something about Hep C that didn't seem quite right to you? You were probably right something was amiss. A discussion about Hepatitis C can...
As per Wikipedia, the definition of a stigma is as follows: "Stigma is a word that originally means a "sign", "point", or "branding mark"." Wikipedia goes on to call stigma "A badge of shame, a physical mark of infamy or disgrace." Damn that w...
Recently, the CDC (Center for Disease Control) issued a statement that all Baby Boomers should be tested for Hepatitis C. The question often comes up as to why this particular segment of people is so vulnerable. What does being born between 1945 and 1965 have to do with Hepatitis C? What was di...
Buyer Beware! There are several snake oil salesmen out there who are claiming to have cured their own Hepatitis C with herbs, supplements and parking lot gravel. Okay, maybe not the parking lot gravel but it might as well be. What you need to remember is that there are two different types of...
Most every adult woman (and an occasional man) has enjoyed a manicure and a pedicure at a nail salon or spa. That 30 minute pedicure can be so relaxing but are you aware of the danger lurking in that nail salon? Although few individuals recognize the medical risks associated with this common pr...
Abstract.
Chronic kidney disease (CKD) is an important cause of morbidity and mortality in HIV-positive individuals. Hepatitis C (HCV) co-infection has been associated with increased risk of CKD, but prior studies lack information on potential mechanisms. We evaluated the association between HCV or hepatitis B (HBV) co-infection and progressive CKD among 3,441 antiretroviral-treated clinical trial participants. Progressive CKD was defined as the composite of end-stage renal disease, renal death, or significant glomerular filtration rate (eGFR) decline (25% decline to eGFR <60 mL/min/1.73 m2 or 25% decline with a baseline <60). Generalized Estimating Equations were used to model the odds of progressive CKD.
At baseline, 13.8% and 3.3% of participants were co-infected with HCV and HBV, respectively. Median eGFR was 111, and 3.7% developed progressive CKD. After adjustment, the odds of progressive CKD were increased in participants with HCV (OR 1.72, 95% CI 1.07–2.76) or HBV (OR 2.26, 95% CI 1.15–4.44). Participants with undetectable or low HCV-RNA had similar odds of progressive CKD as HCV seronegative participants, while participants with HCV-RNA >800,000 IU/ml had increased odds (OR 3.07; 95% CI 1.60–5.90). Interleukin-6, hyaluronic acid, and the FIB-4 hepatic fibrosis index were higher among participants who developed progressive CKD, but were no longer associated with progressive CKD after adjustment. Future studies should validate the relationship between HCV viremia and CKD.
Trial Registration
ClinicalTrials.gov NCT00027352; NCT00004978
Introduction.
In 2006, ten years after the widespread introduction of effective combination antiretroviral therapy (cART) for the treatment of human immunodeficiency virus (HIV) infection, the randomized Strategies for Management of Antiretroviral Therapy trial (SMART) established uninterrupted cART with the goal of continuous viral suppression as the standard of care. [1] Although the primary outcome of SMART focused on mortality and opportunistic illness associated with acquired immunodeficiency syndrome (AIDS), the results also highlighted the growing burden of comorbid disease in the cART era. During an average follow-up of 16 months, serious cardiac, liver, and kidney events were more common than serious AIDS-defining events, regardless of treatment assignment. [1].
Chronic kidney disease (CKD) has been associated with increased morbidity and mortality in HIV-positive individuals receiving cART. [2]–[3] In addition to traditional CKD risk factors such as diabetes and hypertension, co-infection with hepatitis C virus (HCV) has been suggested as a possible risk factor for CKD in HIV-positive individuals. [4] Although there are conflicting data on the relationship between HCV infection and CKD in the general population, meta-analysis of published studies in HIV-positive populations supports an association between HIV-HCV co-infection and increased risk of CKD. [5] The relationship between hepatitis B virus (HBV) infection and CKD has not been as extensively studied, although cross-sectional studies have not demonstrated an association between HBV mono-infection and prevalent CKD. [6]–[7].
Both HBV and HCV have been implicated in the pathogenesis of specific immune complex kidney diseases in the general population and in HIV-positive individuals,[8]–[11] and clinically silent immune complex kidney disease has been observed in HCV mono-infected patients with end-stage liver disease. [12] End-stage liver disease has also been associated with increased risk of overt CKD in HCV-infected individuals, although data on the relative contribution of immune complex disease and hepatorenal syndrome were not available. [13] Previous studies have not investigated other potential mediators of the relationship between viral hepatitis and CKD, including earlier stages of hepatic fibrosis and liver dysfunction, increased levels of systemic inflammation, or nephrotoxic effects of antiviral therapy for HBV or HCV. In addition, the majority of prior studies defined viral hepatitis co-infection by serology alone, and did not report data on HBV DNA, HCV RNA, or HCV genotype as potential mediators or effectors of the relationship between viral hepatitis and CKD.
We evaluated the association between viral hepatitis co-infection and progressive CKD among 3,441 cART-treated participants enrolled in two large international HIV treatment trials, with the goal of identifying potential mediators of the relationship.
Please sign the ATC Salvage Therapy Petition Join us in asking Congressman Alcee Hastings and Congresswomen Maxine Waters to send a ‘Dear Colleague’ letter to Anthony Fauci, Director of NIAID, asking for the federal facilitation of apricitabine (ATC). ATC is a phase III nucleoside reverse transcriptase inhibitor (NRTI) that has been shown to be safe and effective in treating people with HIV. It works against viruses that are resistant to several other nukes and could ...
Researchers from Johns Hopkins Children’s Center, the University of Mississippi Medical Center and the University of Massachusetts Medical School announced today at CROI2013 the discovery of the first infant functionally cured of HIV. The baby, a female now two and a half years old, received 3 HIV medications when brought to the hospital at 30 hours old. Viral load tests were performed during the first few weeks that showed a rapidly decreasing viral load which reached ...
At the 19th International AIDS Conference (AIDS 2012) in Washington D.C., the CDC reported that only 1 out of 4 HIV patients in the U.S. have HIV under control, which is defined as complete viral suppression. Warning bells should be ringing in the scientific and HIV advocacy communities. While much progress has been made in the last three decades in the treatment of HIV, tens of thousands of people living with HIV (PLWH) are currently struggling to construct viable treat...
Paige Rawl is 17 and HIV positive, but while her life has been shaped by HIV it isn't ruled by it. When Paige Rawl starts her senior year at Indianapolis’s Herron High School next month, she'll be cheer captain and a member of the student government and prom committee. This summer, the 17-year-old held down a part-time job at Hollister, hawking the popular Southern California-inspired clothing brand. The all-American girl — who happens to be HIV positive. Paige was in...
The HIV community has been abuzz with the August FDA approval of what had been termed “the Quad”, the second one-pill-once-a-day combination antiretroviral drug. Marketed by Gilead under the name Stribild, the drug contains two NRTIs (tenofovir and emtricitabine), an integrase inhibitor (elvitegravir) and an integrase booster (cobicistat) and is approved for use in treatment naïve patients with either drug resistant or wild type virus. In comparison to Atripla, the first...
Bristol-Myers Squibb Company (NYSE: BMY) today announced that the U.S. Food and Drug Administration (FDA) has approved a supplemental new drug application (sNDA) for SUSTIVA® (efavirenz), including dosing recommendations for...
California and other states would be pressured to amend or repeal criminal laws that single out HIV-positive people under a bipartisan bill co-authored and introduced this week by Rep. Barbara...
Mission Statement
At HIV Haven we wish to provide our readers with vital cutting edge information to help expand HIV knowledge and promote activism, particularly that which works towards an end to the HIV pandemic. It is our desire to bring to you the scientific, medical and social advances that given the appropriate attention and support, could change the course of the HIV pandemic, lessen the devastating effects of HIV and AIDS, better the quality and quantity of life for people living with HIV and even yield an eventual end to the HIV pandemic. We also provide the basics of HIV transmission and treatment.
We will focus on issues such as innovative drug development, strategic activist campaigns, HIV relationships and novel HIV and HIV cure research. We also will bring you advances in Hepatitis C (HCV), a common HIV co-infection. Whether you are living with HIV/AIDS, HIV and HCV, love someone who is, are an activist, advocate, researcher, physician or just an interested party, we hope here at HIV Haven we can help you find what you are looking for.
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