Reconciling the evaluation of co-morbidities among HIV care patients in two large data systems: the Medical Monitoring Project and CFAR Network of Integrated Clinical Systems

Hood, Julia; Bradley, Heather; Golden, Matthew R.; Crane, Heidi M.; Buskin, Susan E.; Burkholder, Greer A.; Geng, Elvin; Kitahata, Mari M.; Mathews, William C; Moore, Richard D.; Hawes, Stephen E.

doi:10.1080/09540121.2018.1499855

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Ordinary least squares regression was used to determine whether the inclusion of race or surrogates of race, APOL1 variants and genetic African ancestry, improved ability to predict log-transformed serum creatinine. Additional variables considered for model inclusion included age at study entry, birth sex, BMI [32], hypertension [32], diabetes [33], hepatitis C infection [34], hepatitis B infection [34], history of intravenous drug use [35], CD4 + cell count, log-transformed HIV viral load, tenofovir use, protease inhibitor use, indinavir use, atazanavir use, lopinavir use, integrase inhibitor use, and overall antiretroviral therapy use. Model residuals were assessed for functional form of continuous variables, and all models were tested for collinearity of variables using the variance inflation factor.…”

Section: Methodsmentioning

confidence: 99%

African American/black race, Apolipoprotein L1, and the indirect glomerular filtration measure serum creatinine among persons living with HIV

Shelton,

Sawinski,

Peter

et al. 2023

Aids

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Objective: Accurate estimation of kidney function is critical among people living with HIV (PLWH) to avoid under-dosing of antiretroviral therapies and ensure timely referral for kidney transplantation. Existing estimation equations for kidney function include race, the appropriateness of which has been debated. Given advancements in understanding of race and the necessity of accuracy in kidney function estimation, this study aimed to examine whether race, or genetic factors, improved prediction of serum creatinine among PLWH. Design: This cross-sectional study utilized data from the Center for AIDS Research Network of Integrated Clinical Systems cohort (2008–2018). The outcome was baseline serum creatinine. Methods: Ordinary least squares regression was used to examine whether inclusion of race or genetic factors (apolipoprotein-L1 (APOL1) variants and genetic African ancestry) improved serum creatinine prediction. A reduction in root mean squared error (RMSE) >2% was a clinically relevant improvement in predictive ability. Results: There were 4,183 PLWH included. Among PLWH whose serum creatinine <1.7 mg/dL, race was significantly associated with serum creatinine (β = 0.06, SE = 0.01, p < 0.001), but did not improve predictive ability. African ancestry and APOL1 variants similarly failed to improve predictive ability. Whereas, when serum creatinine ≥1.7 mg/dL, inclusion of race reduced the RMSE by 2.1%, indicating improvement in predictive ability. APOL1 variants further improved predictive ability by reducing the RMSE by 2.9% Conclusions: These data suggest that, among PLWH, inclusion of race or genetic factors may only be warranted at higher serum creatinine levels. Work eliminating existing healthcare disparities while preserving the utility of estimating equations is needed.

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Section: Methodsmentioning

confidence: 99%

African American/black race, Apolipoprotein L1, and the indirect glomerular filtration measure serum creatinine among persons living with HIV

Shelton,

Sawinski,

Peter

et al. 2023

Aids

Self Cite

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“…The population of PLWH is aging and has a high burden of comorbidities, including hypertension, diabetes, and dyslipidemia, which contribute to an increased incidence of cardiovascular and cerebrovascular disease. [58][59][60][61] These comorbidities may compromise their candidacy for transplant.…”

Section: Pretransplant Evaluation and Optimization For Transplantmentioning

confidence: 99%

Expanding Access to Organ Transplant for People Living With HIV: Can Policy Catch Up to Outcomes Data?

Chandran,

Stock,

Roll

2023

Transplantation

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Advances in antiretroviral and immunosuppressive regimens have improved outcomes following solid organ transplantation in people living with HIV (PLWH). The HIV Organ Policy and Equity Act was conceived to reduce the discard of HIV-positive organs and improve access to transplant for PLWH. Nevertheless, PLWH continue to experience disproportionately low rates of transplant. This overview examines the hurdles to transplantation in PLWH with end-organ disease, the potential and realized impact of the HIV Organ Policy and Equity Act, and changes that could permit expanded access to organ transplant in this population.

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Molecular epidemiology in the HIV and SARS-CoV-2 pandemics

Lorenzo-Redondo

Ozer

Achenbach

et al. 2020

Current Opinion in HIV and AIDS

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Purpose of review The aim of this review was to compare and contrast the application of molecular epidemiology approaches for the improved management and understanding of the HIV versus SARS-CoV-2 epidemics. Recent findings Molecular biology approaches, including PCR and whole genome sequencing (WGS), have become powerful tools for epidemiological investigation. PCR approaches form the basis for many high-sensitivity diagnostic tests and can supplement traditional contact tracing and surveillance strategies to define risk networks and transmission patterns. WGS approaches can further define the causative agents of disease, trace the origins of the pathogen, and clarify routes of transmission. When coupled with clinical datasets, such as electronic medical record data, these approaches can investigate co-correlates of disease and pathogenesis. In the ongoing HIV epidemic, these approaches have been effectively deployed to identify treatment gaps, transmission clusters and risk factors, though significant barriers to rapid or real-time implementation remain critical to overcome. Likewise, these approaches have been successful in addressing some questions of SARS-CoV-2 transmission and pathogenesis, but the nature and rapid spread of the virus have posed additional challenges. Summary Overall, molecular epidemiology approaches offer unique advantages and challenges that complement traditional epidemiological tools for the improved understanding and management of epidemics.

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Reconciling the evaluation of co-morbidities among HIV care patients in two large data systems: the Medical Monitoring Project and CFAR Network of Integrated Clinical Systems

Cited by 3 publications

References 25 publications

African American/black race, Apolipoprotein L1, and the indirect glomerular filtration measure serum creatinine among persons living with HIV

African American/black race, Apolipoprotein L1, and the indirect glomerular filtration measure serum creatinine among persons living with HIV

Expanding Access to Organ Transplant for People Living With HIV: Can Policy Catch Up to Outcomes Data?

Molecular epidemiology in the HIV and SARS-CoV-2 pandemics

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