2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2005040340v1 16/8/2412    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schwartz, E. J. Articles by Klotman, P. E. Search for Related Content PubMed PubMed Citation Articles by Schwartz, E. J. Articles by Klotman, P. E.

Highly Active Antiretroviral Therapy and the Epidemic of HIV+ End-Stage Renal Disease

Elissa J. Schwartz^*, Lynda A. Szczech, Michael J. Ross^*, Mary E. Klotman, Jonathan A. Winston^* and Paul E. Klotman^*

^* Division of Nephrology; Division of Infectious Diseases, Mount Sinai Medical Center, New York, New York; and Division of Nephrology, Duke University Medical Center, Durham, North Carolina

Address correspondence to: Dr. Paul E. Klotman, Mount Sinai Medical Center, Box 1118, One Gustave L. Levy Place, New York, NY 10029. Phone: 212-241-4200; Fax: 212-876-5844; E-mail: paul.klotman{at}mssm.edu

The rise in the number of patients with HIV-associated nephropathy and HIV-infection with end-stage renal disease (HIV+ ESRD) continues to be a substantial concern for the ESRD program. In order to assess the impact of highly active antiretroviral therapy (HAART) on the progression of patients with AIDS to the development of ESRD and to project the prevalence of HIV+ ESRD through 2020, a mathematical model of the dynamics of HIV+ infection in the ESRD population was developed. Epidemiologic data on AIDS and HIV+ ESRD among black individuals in the United States were obtained since 1991 from the Centers for Disease Control and Prevention and US Renal Data System, respectively. The model was constructed to predict the prevalence of HIV+ ESRD incorporating the current rate of growth in AIDS prevalence. Two possible trends were considered: linear AIDS growth and exponential AIDS growth. The likely effectiveness of HAART in slowing progression to HIV+ ESRD was estimated from the best fit of the model to the data after 1995, when HAART was introduced. The model was then used to evaluate recent data and to project the prevalence of HIV+ ESRD through 2020. The model suggested that HAART has reduced the rate of progression from AIDS to HIV+ ESRD by 38%. The model projected an increase in HIV+ ESRD prevalence in the future as a result of the increase in the AIDS population among black individuals. This increase was predicted even assuming a 95% reduction in the progression from AIDS to HIV+ ESRD. Despite the potential benefit of HAART, the prevalence of HIV+ ESRD in the United States is expected to rise in the future as a result of the expansion of the AIDS population among black individuals. It is concluded that prevention of progression to ESRD should focus on early antiretroviral treatment of HIV-infected patients who have evidence of HIV-associated nephropathy.

This article has been cited by other articles:

				M. Baekken, I. Os, L. Sandvik, and O. Oektedalen Microalbuminuria associated with indicators of inflammatory activity in an HIV-positive population Nephrol. Dial. Transplant., October 1, 2008; 23(10): 3130 - 3137. [Abstract] [Full Text] [PDF]

				C. Y. Cheung, K. M. Wong, M. P. Lee, Y. L. Liu, H. Kwok, R. Chung, K. F. Chau, C. K. Li, and C. S. Li Prevalence of chronic kidney disease in Chinese HIV-infected patients Nephrol. Dial. Transplant., November 1, 2007; 22(11): 3186 - 3190. [Abstract] [Full Text] [PDF]

				A. I. Choi, R. A. Rodriguez, P. Bacchetti, D. Bertenthal, P. A. Volberding, and A. M. O'Hare Racial Differences in End-Stage Renal Disease Rates in HIV Infection versus Diabetes J. Am. Soc. Nephrol., November 1, 2007; 18(11): 2968 - 2974. [Abstract] [Full Text] [PDF]

				S. D. Cohen and P. L. Kimmel HIV-associated renal diseases in Africa a desperate need for additional study Nephrol. Dial. Transplant., August 1, 2007; 22(8): 2116 - 2119. [Full Text] [PDF]

				C. M. Wyatt and P. E. Klotman HIV-1 and HIV-Associated Nephropathy 25 Years Later Clin. J. Am. Soc. Nephrol., July 1, 2007; 2(Supplement_1): S20 - S24. [Abstract] [Full Text] [PDF]

				N. Hiramatsu, K. Hiromura, T. Shigehara, T. Kuroiwa, H. Ideura, N. Sakurai, S. Takeuchi, M. Tomioka, H. Ikeuchi, Y. Kaneko, et al. Angiotensin II Type 1 Receptor Blockade Inhibits the Development and Progression of HIV-Associated Nephropathy in a Mouse Model J. Am. Soc. Nephrol., February 1, 2007; 18(2): 515 - 527. [Abstract] [Full Text] [PDF]

				M. Albaqumi, T. J. Soos, L. Barisoni, and P. J. Nelson Collapsing Glomerulopathy J. Am. Soc. Nephrol., October 1, 2006; 17(10): 2854 - 2863. [Abstract] [Full Text] [PDF]

				J. S. Berns and N. Kasbekar Highly Active Antiretroviral Therapy and the Kidney: An Update on Antiretroviral Medications for Nephrologists Clin. J. Am. Soc. Nephrol., January 1, 2006; 1(1): 117 - 129. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673