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Hepatitus C in Women with HIV
Article by Sonia Nichols, Hepatitis Weekly (02.11.02). Reprinted courtesy GENDER-AIDS 2002. February 25, 2002
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Researchers have cited Hepatitis C virus (HCV) co-infection as well as several other factors for causing proteinuria and kidney failure in women infected with HIV, in a study published in the January 2002 issue of Kidney International (Predictors of Proteinuria and Renal Failure Among Women with HIV Infection, 2002;61(1):195-202).
The multicentre team, led by Duke University Medical Center investigator Lynda Anne Szczech, performed a prospective evaluation of more than
2 000 female participants in the Women's Interagency HIV study (WIHS).
In their analysis, a patient's race, HCV co-infection status and T-cell count, among other findings, played prominent roles in the risk of kidney disease in females infected with HIV. Szczech and co-workers described the WIHS as a long-term study specifically targeting the clinical characteristics of HIV and its progression or regression in females.
During the ongoing study, participants are checked bi-annually for several parameters of HIV pathogenesis, including kidney function, immune system response, and viral replication. Using statistical analysis, researchers have outlined several factors for renal disease and progression in HIV-infected women:
* Of 2 057 HIV-positive women, 32 percent had proteinuria on initial evaluation. Proteinuria is a significant sign that the kidneys are notfunctioning properly.
* Being a black female doubled the risk for proteinuria, while having CD4 cell counts less than or equal to 200, having increasing HIV levels, and being co-infected with HCV were also proteinuria risk factors.
* With respect to developing renal failure - low T-cell counts, falling albumin levels, detectable HIV RNA levels, increasing creatinine levels, and rising systolic blood pressure levels, in that order, were significant risk factors.
To reduce the risks for kidney disease in HIV positive patients, Szczech and colleagues proposed that research initiatives should focus on suppressing HIV RNA levels and improving immune system response. |
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