The impact of hepatitis C virus coinfection on HIV-related kidney disease: A systematic review and meta-analysis

Christina M. Wyatt, Carlos Malvestutto, Steven G. Coca, Paul E. Klotman, Chirag R. Parikh

Research output: Contribution to journalArticlepeer-review

82 Scopus citations


BACKGROUND: In the era of antiretroviral therapy, non-AIDS complications such as kidney disease are important contributors to morbidity and mortality. OBJECTIVE: To estimate the impact of hepatitis C coinfection on the risk of kidney disease in HIV patients. DESIGN AND METHODS: Two investigators identified English-language citations in MEDLINE and Web of Science from 1989 through 1 July 2007. References of selected articles were reviewed. Observational studies and clinical trials of HIV-related kidney disease and antiretroviral nephrotoxicity were eligible if they included at least 50 subjects and reported hepatitis C status. Data on study characteristics, population, and kidney disease outcomes were abstracted by two independent reviewers. RESULTS: After screening 2516 articles, 27 studies were eligible and 24 authors confirmed or provided data. Separate meta-analyses were performed for chronic kidney disease outcomes (n ≤ 10), proteinuria (n ≤ 4), acute renal failure (n ≤ 2), and indinavir toxicity (n ≤ 5). The pooled incidence of chronic kidney disease was higher in patients with hepatitis C coinfection [6.2 versus 4.0%; relative risk 1.49, 95% confidence interval (CI) 1.08-2.06]. In meta-regression, prevalence of black race and the proportion of patients with documented hepatitis C status were independently associated with the risk of chronic kidney disease. The relative risk associated with hepatitis C coinfection was significantly increased for proteinuria (1.15; 95% CI 1.02-1.30) and acute renal failure (1.64; 95% CI 1.21-2.23), with no significant statistical heterogeneity. The relative risk of indinavir toxicity was 1.59 (95% CI 0.99-2.54) with hepatitis C coinfection. CONCLUSION: Hepatitis C coinfection is associated with a significant increase in the risk of HIV-related kidney disease.

Original languageEnglish (US)
Pages (from-to)1799-1807
Number of pages9
Issue number14
StatePublished - Sep 12 2008
Externally publishedYes


  • HIV
  • Hepatitis C
  • Hepatitis coinfection
  • Kidney disease
  • Nephrotoxicity

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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