Incident Proteinuria by HIV Serostatus among Men with Pre - Diabetes Mellitus: The Multicenter AIDS Cohort Study

mulicenter AIDS Cohort Study (MACS)

doi:10.1093/cid/ciae065

Incident Proteinuria by HIV Serostatus among Men with Pre - Diabetes Mellitus: The Multicenter AIDS Cohort Study

mulicenter AIDS Cohort Study (MACS)

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Pre-diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons. Methods: The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100-125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%-6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria. Results: Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3-4.8 times) greater than in PWOH (P <. 01). Among PWH, current CD4 cell count <50/μL (P <. 01) and current use of protease inhibitors (P =. 03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk. Conclusions: Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.

Original language	English (US)
Pages (from-to)	469-476
Number of pages	8
Journal	Clinical Infectious Diseases
Volume	79
Issue number	2
DOIs	https://doi.org/10.1093/cid/ciae065
State	Published - Aug 15 2024

Funding

Potential conflicts of interest. L. S. declares consulting fees, support for attending meetings, and payment for presentation from Gilead Sciences, ViiV Healthcare, and Merck, outside the present work. A. G. A. declares a National Heart, Lung, and Blood Institute grant paid to her institution. F. J. P. declares payment from ViiV, Gilead Sciences, Janssen, Merck, and EMD Serono, outside the present work. J. W. M. declares a NIH/NHLBI research grant to the University of Pittsburgh and is an American Heart Association committee member. J. E. L. declares research support from Gilead Sciences, Pfizer, Oncoimmune, and CytoDyn, all paid to her institution; consulting fees for Theratechnologies; and stock options from CytoDyn. T. T. B. declares consulting fees from Merck, Janssen, Gilead Sciences, and ViiV Healthcare, outside the present work. All other authors report no potential conflicts. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), the National Institute on Aging (NIA), the National Institute of Dental & Craniofacial Research (NIDCR), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), the National Institute of Nursing Research (NINR), the National Cancer Institute (NCI), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and Other Communication Disorders (NIDCD), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the NIH, Office of AIDS Research (OAR). The NIH grant numbers supporting the MWCCS sites are: U01-HL146241, U01-HL146201, U01-HL146204, U01-HL146193, U01-HL146245, U01-HL146240, U01-HL146242, U01-HL146333, U01-HL146205, U01-HL146203, U01-HL146208, U01-HL146192, U01-HL146194. MWCCS data collection is also supported by NIH grants UL1-TR000004, UL1-TR003098, UL1-TR001881, P30-AI-050409, P30-AI-073961, P30-AI-050410, P30-AI-027767, P30-MH-116867, UL1-TR001409, KL2-TR001432, and TL1-TR001431. The authors gratefully acknowledge the contributions of the study participants and dedication of the staff at the Multicenter AIDS Cohort Study (MACS)/WIHS (Women's Interagency HIV Study) Combined Cohort Study (MWCCS) sites. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), the National Institute on Aging (NIA), the National Institute of Dental & Craniofacial Research (NIDCR), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), the National Institute of Nursing Research (NINR), the National Cancer Institute (NCI), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and Other Communication Disorders (NIDCD), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the NIH, Office of AIDS Research (OAR). The NIH grant numbers supporting the MWCCS sites are: U01-HL146241, U01-HL146201, U01-HL146204, U01-HL146193, U01-HL146245, U01-HL146240, U01-HL146242, U01-HL146333, U01-HL146205, U01-HL146203, U01-HL146208, U01-HL146192, U01-HL146194. MWCCS data collection is also supported by NIH grants UL1-TR000004, UL1-TR003098, UL1-TR001881, P30-AI-050409, P30-AI-073961, P30-AI-050410, P30-AI-027767, P30-MH-116867, UL1-TR001409, KL2-TR001432, and TL1-TR001431.

Keywords

HIV
MACS
diabetes
incident proteinuria
pre-diabetes

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/cid/ciae065

Cite this

@article{b9a1b96df55c43d4a5d6132983ff4a97,

title = "Incident Proteinuria by HIV Serostatus among Men with Pre - Diabetes Mellitus: The Multicenter AIDS Cohort Study",

abstract = "Background: Pre-diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons. Methods: The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100-125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%-6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria. Results: Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3-4.8 times) greater than in PWOH (P <. 01). Among PWH, current CD4 cell count <50/μL (P <. 01) and current use of protease inhibitors (P =. 03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk. Conclusions: Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.",

keywords = "HIV, MACS, diabetes, incident proteinuria, pre-diabetes",

author = "{mulicenter AIDS Cohort Study (MACS)} and Laurence Slama and Barrett, {Benjamin W.} and Abraham, {Alison G.} and Palella, {Frank J.} and Magnani, {Jared W.} and Viard, {Jean Paul} and Lake, {Jordan E.} and Brown, {Todd T.} and Ighovwerha Ofotokun and Anandi Sheth and Gina Wingood and Joseph Margolick and Kathryn Anastos and David Hanna and Anjali Sharma and Deborah Gustafson and Tracey Wilson and Gypsyamber D'Souza and Stephen Gange and Elizabeth Topper and Mardge Cohen and Audrey French and Steven Wolinsky and Valentina Stosor and Bradley Aouizerat and Jennifer Price and Phyllis Tien and Roger Detels and Matthew Mimiaga and Seble Kassaye and Daniel Merenstein and Maria Alcaide and Margaret Fischl and Deborah Jones and Jeremy Martinson and Charles Rinaldo and Kempf, {Mirjam Colette} and Jodie Dionne-Odom and Deborah Konkle-Parker and Brock, {James B.} and Bradley Drummond and Michelle Floris-Moore",

year = "2024",

month = aug,

day = "15",

doi = "10.1093/cid/ciae065",

language = "English (US)",

volume = "79",

pages = "469--476",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - Incident Proteinuria by HIV Serostatus among Men with Pre - Diabetes Mellitus

T2 - The Multicenter AIDS Cohort Study

AU - mulicenter AIDS Cohort Study (MACS)

AU - Slama, Laurence

AU - Barrett, Benjamin W.

AU - Abraham, Alison G.

AU - Palella, Frank J.

AU - Magnani, Jared W.

AU - Viard, Jean Paul

AU - Lake, Jordan E.

AU - Brown, Todd T.

AU - Ofotokun, Ighovwerha

AU - Sheth, Anandi

AU - Wingood, Gina

AU - Margolick, Joseph

AU - Anastos, Kathryn

AU - Hanna, David

AU - Sharma, Anjali

AU - Gustafson, Deborah

AU - Wilson, Tracey

AU - D'Souza, Gypsyamber

AU - Gange, Stephen

AU - Topper, Elizabeth

AU - Cohen, Mardge

AU - French, Audrey

AU - Wolinsky, Steven

AU - Stosor, Valentina

AU - Aouizerat, Bradley

AU - Price, Jennifer

AU - Tien, Phyllis

AU - Detels, Roger

AU - Mimiaga, Matthew

AU - Kassaye, Seble

AU - Merenstein, Daniel

AU - Alcaide, Maria

AU - Fischl, Margaret

AU - Jones, Deborah

AU - Martinson, Jeremy

AU - Rinaldo, Charles

AU - Kempf, Mirjam Colette

AU - Dionne-Odom, Jodie

AU - Konkle-Parker, Deborah

AU - Brock, James B.

AU - Drummond, Bradley

AU - Floris-Moore, Michelle

PY - 2024/8/15

Y1 - 2024/8/15

N2 - Background: Pre-diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons. Methods: The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100-125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%-6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria. Results: Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3-4.8 times) greater than in PWOH (P <. 01). Among PWH, current CD4 cell count <50/μL (P <. 01) and current use of protease inhibitors (P =. 03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk. Conclusions: Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.

AB - Background: Pre-diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons. Methods: The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100-125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%-6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria. Results: Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3-4.8 times) greater than in PWOH (P <. 01). Among PWH, current CD4 cell count <50/μL (P <. 01) and current use of protease inhibitors (P =. 03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk. Conclusions: Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.

KW - HIV

KW - MACS

KW - diabetes

KW - incident proteinuria

KW - pre-diabetes

UR - http://www.scopus.com/inward/record.url?scp=85201437656&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85201437656&partnerID=8YFLogxK

U2 - 10.1093/cid/ciae065

DO - 10.1093/cid/ciae065

M3 - Article

C2 - 38335094

AN - SCOPUS:85201437656

SN - 1058-4838

VL - 79

SP - 469

EP - 476

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 2

ER -

Incident Proteinuria by HIV Serostatus among Men with Pre - Diabetes Mellitus: The Multicenter AIDS Cohort Study

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this