The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era

Samir Gupta, Marlene Smurzynski, Nora Franceschini, Ronald J. Bosch, Lynda A. Szczech, Robert C. Kalayjian

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Proteinuria is associated with progressive renal disease and overall mortality in HIV-infected patients; however, the prevalence and correlates of quantitative proteinuria in the highly active antiretroviral therapy era are unknown. Methods: Spot urine protein to creatinine (P/Cr) ratios, an accepted measure of quantitative daily proteinuria, were measured annually since 2002 in participants of the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort. We used linear regression models with general estimating equations to identify factors associated with the abnormal P/Cr thresholds of ≥0.2 and ≥1.0. Results: Of the 2,857 participants (most of whom were receiving antiretroviral therapy) analysed, 16% and 3% had P/Cr levels ≥0.2 and ≥1.0, respectively, at first measurement. P/Cr levels did not change during a median follow-up of 3 years (interquartile range 2-4). Factors associated with P/Cr≥0.2 at any measurement included greater age, lower glomerular filtration rate, female sex. antiretroviral therapy prior to entry into parent randomized trial, HIV type-1 RNA level ≥400 copies/ml, lower CD4+ T-cell count and history of hypertension, diabetes or hepatitis C coinfection (all P<0.04). Black race and higher non-high-density lipoprotein cholesterol levels were associated with P/Cr levels ≥1.0. but not with P/Cr levels ≥0.2. Hepatitis B coinfection and current use of adefovir, indinavir and tenofovir were not associated with either of the P/Cr thresholds. Conclusions: Both HIV-1 and non-HIV-1 -related factors are associated with abnormal levels of proteinuria and identify those who are at a greater risk of worse clinical outcomes. Several of these factors are differentially associated with lower and higher proteinuria thresholds.

Original languageEnglish
Pages (from-to)543-549
Number of pages7
JournalAntiviral Therapy
Volume14
Issue number4
StatePublished - 2009

Fingerprint

Highly Active Antiretroviral Therapy
Proteinuria
HIV-1
Creatinine
Proteins
Tenofovir
Coinfection
Linear Models
Indinavir
CD4 Lymphocyte Count
Hepatitis C
Hepatitis B
Glomerular Filtration Rate
Acquired Immunodeficiency Syndrome
Clinical Trials
HIV
Urine
RNA
Hypertension
T-Lymphocytes

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Gupta, S., Smurzynski, M., Franceschini, N., Bosch, R. J., Szczech, L. A., & Kalayjian, R. C. (2009). The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era. Antiviral Therapy, 14(4), 543-549.

The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era. / Gupta, Samir; Smurzynski, Marlene; Franceschini, Nora; Bosch, Ronald J.; Szczech, Lynda A.; Kalayjian, Robert C.

In: Antiviral Therapy, Vol. 14, No. 4, 2009, p. 543-549.

Research output: Contribution to journalArticle

Gupta, S, Smurzynski, M, Franceschini, N, Bosch, RJ, Szczech, LA & Kalayjian, RC 2009, 'The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era', Antiviral Therapy, vol. 14, no. 4, pp. 543-549.
Gupta, Samir ; Smurzynski, Marlene ; Franceschini, Nora ; Bosch, Ronald J. ; Szczech, Lynda A. ; Kalayjian, Robert C. / The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era. In: Antiviral Therapy. 2009 ; Vol. 14, No. 4. pp. 543-549.
@article{315ad2966afc4b349af64fcf3c2c2370,
title = "The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era",
abstract = "Background: Proteinuria is associated with progressive renal disease and overall mortality in HIV-infected patients; however, the prevalence and correlates of quantitative proteinuria in the highly active antiretroviral therapy era are unknown. Methods: Spot urine protein to creatinine (P/Cr) ratios, an accepted measure of quantitative daily proteinuria, were measured annually since 2002 in participants of the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort. We used linear regression models with general estimating equations to identify factors associated with the abnormal P/Cr thresholds of ≥0.2 and ≥1.0. Results: Of the 2,857 participants (most of whom were receiving antiretroviral therapy) analysed, 16{\%} and 3{\%} had P/Cr levels ≥0.2 and ≥1.0, respectively, at first measurement. P/Cr levels did not change during a median follow-up of 3 years (interquartile range 2-4). Factors associated with P/Cr≥0.2 at any measurement included greater age, lower glomerular filtration rate, female sex. antiretroviral therapy prior to entry into parent randomized trial, HIV type-1 RNA level ≥400 copies/ml, lower CD4+ T-cell count and history of hypertension, diabetes or hepatitis C coinfection (all P<0.04). Black race and higher non-high-density lipoprotein cholesterol levels were associated with P/Cr levels ≥1.0. but not with P/Cr levels ≥0.2. Hepatitis B coinfection and current use of adefovir, indinavir and tenofovir were not associated with either of the P/Cr thresholds. Conclusions: Both HIV-1 and non-HIV-1 -related factors are associated with abnormal levels of proteinuria and identify those who are at a greater risk of worse clinical outcomes. Several of these factors are differentially associated with lower and higher proteinuria thresholds.",
author = "Samir Gupta and Marlene Smurzynski and Nora Franceschini and Bosch, {Ronald J.} and Szczech, {Lynda A.} and Kalayjian, {Robert C.}",
year = "2009",
language = "English",
volume = "14",
pages = "543--549",
journal = "Antiviral Therapy",
issn = "1359-6535",
publisher = "International Medical Press Ltd",
number = "4",

}

TY - JOUR

T1 - The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era

AU - Gupta, Samir

AU - Smurzynski, Marlene

AU - Franceschini, Nora

AU - Bosch, Ronald J.

AU - Szczech, Lynda A.

AU - Kalayjian, Robert C.

PY - 2009

Y1 - 2009

N2 - Background: Proteinuria is associated with progressive renal disease and overall mortality in HIV-infected patients; however, the prevalence and correlates of quantitative proteinuria in the highly active antiretroviral therapy era are unknown. Methods: Spot urine protein to creatinine (P/Cr) ratios, an accepted measure of quantitative daily proteinuria, were measured annually since 2002 in participants of the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort. We used linear regression models with general estimating equations to identify factors associated with the abnormal P/Cr thresholds of ≥0.2 and ≥1.0. Results: Of the 2,857 participants (most of whom were receiving antiretroviral therapy) analysed, 16% and 3% had P/Cr levels ≥0.2 and ≥1.0, respectively, at first measurement. P/Cr levels did not change during a median follow-up of 3 years (interquartile range 2-4). Factors associated with P/Cr≥0.2 at any measurement included greater age, lower glomerular filtration rate, female sex. antiretroviral therapy prior to entry into parent randomized trial, HIV type-1 RNA level ≥400 copies/ml, lower CD4+ T-cell count and history of hypertension, diabetes or hepatitis C coinfection (all P<0.04). Black race and higher non-high-density lipoprotein cholesterol levels were associated with P/Cr levels ≥1.0. but not with P/Cr levels ≥0.2. Hepatitis B coinfection and current use of adefovir, indinavir and tenofovir were not associated with either of the P/Cr thresholds. Conclusions: Both HIV-1 and non-HIV-1 -related factors are associated with abnormal levels of proteinuria and identify those who are at a greater risk of worse clinical outcomes. Several of these factors are differentially associated with lower and higher proteinuria thresholds.

AB - Background: Proteinuria is associated with progressive renal disease and overall mortality in HIV-infected patients; however, the prevalence and correlates of quantitative proteinuria in the highly active antiretroviral therapy era are unknown. Methods: Spot urine protein to creatinine (P/Cr) ratios, an accepted measure of quantitative daily proteinuria, were measured annually since 2002 in participants of the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort. We used linear regression models with general estimating equations to identify factors associated with the abnormal P/Cr thresholds of ≥0.2 and ≥1.0. Results: Of the 2,857 participants (most of whom were receiving antiretroviral therapy) analysed, 16% and 3% had P/Cr levels ≥0.2 and ≥1.0, respectively, at first measurement. P/Cr levels did not change during a median follow-up of 3 years (interquartile range 2-4). Factors associated with P/Cr≥0.2 at any measurement included greater age, lower glomerular filtration rate, female sex. antiretroviral therapy prior to entry into parent randomized trial, HIV type-1 RNA level ≥400 copies/ml, lower CD4+ T-cell count and history of hypertension, diabetes or hepatitis C coinfection (all P<0.04). Black race and higher non-high-density lipoprotein cholesterol levels were associated with P/Cr levels ≥1.0. but not with P/Cr levels ≥0.2. Hepatitis B coinfection and current use of adefovir, indinavir and tenofovir were not associated with either of the P/Cr thresholds. Conclusions: Both HIV-1 and non-HIV-1 -related factors are associated with abnormal levels of proteinuria and identify those who are at a greater risk of worse clinical outcomes. Several of these factors are differentially associated with lower and higher proteinuria thresholds.

UR - http://www.scopus.com/inward/record.url?scp=68549110311&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68549110311&partnerID=8YFLogxK

M3 - Article

VL - 14

SP - 543

EP - 549

JO - Antiviral Therapy

JF - Antiviral Therapy

SN - 1359-6535

IS - 4

ER -