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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study</title>
<author><name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ross, Mike" sort="Ross, Mike" uniqKey="Ross M" first="Mike" last="Ross">Mike Ross</name>
<affiliation><nlm:aff id="af2"><addr-line>Division of Nephrology</addr-line>
,<institution>Mount Sinai School of Medicine</institution>
,<country>New York</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name>
<affiliation><nlm:aff id="af3"><institution>Kirby Institute, University of New South Wales</institution>
,<addr-line>Sydney</addr-line>
,<country>Australia</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Morlat, Philippe" sort="Morlat, Philippe" uniqKey="Morlat P" first="Philippe" last="Morlat">Philippe Morlat</name>
<affiliation><nlm:aff id="af4"><institution>Université Bordeaux, INSERM U 897, CHU de Bordeaux</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fontas, Eric" sort="Fontas, Eric" uniqKey="Fontas E" first="Eric" last="Fontas">Eric Fontas</name>
<affiliation><nlm:aff id="af5"><addr-line>Nephrology Department, Public Health Department</addr-line>
,<institution>CHU Nice</institution>
,<country>France</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Smit, Colette" sort="Smit, Colette" uniqKey="Smit C" first="Colette" last="Smit">Colette Smit</name>
<affiliation><nlm:aff id="af6"><addr-line>Academic Medical Center, Division of Infectious Diseases</addr-line>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af7"><addr-line>Department of Global Health</addr-line>
,<institution>University of Amsterdam</institution>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af8"><institution>HIV Monitoring Foundation</institution>
,<addr-line>Amsterdam</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fux, Christoph A" sort="Fux, Christoph A" uniqKey="Fux C" first="Christoph A." last="Fux">Christoph A. Fux</name>
<affiliation><nlm:aff id="af9"><addr-line>Clinic for Infectious Diseases and Hospital Hygiene</addr-line>
,<institution>Kantonsspital Aarau</institution>
,<country>Switzerland</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hatleberg, Camilla I" sort="Hatleberg, Camilla I" uniqKey="Hatleberg C" first="Camilla I." last="Hatleberg">Camilla I. Hatleberg</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stéphane" last="De Wit">Stéphane De Wit</name>
<affiliation><nlm:aff id="af10"><addr-line>Department of Infectious Diseases</addr-line>
,<institution>CHU Saint-Pierre</institution>
,<addr-line>Brussels</addr-line>
,<country>Belgium</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name>
<affiliation><nlm:aff id="af11"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name>
<affiliation><nlm:aff id="af11"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">27485357</idno>
<idno type="pmc">5034954</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034954</idno>
<idno type="RBID">PMC:5034954</idno>
<idno type="doi">10.1093/infdis/jiw342</idno>
<date when="2016">2016</date>
<idno type="wicri:Area/Pmc/Corpus">001973</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001973</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study</title>
<author><name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ross, Mike" sort="Ross, Mike" uniqKey="Ross M" first="Mike" last="Ross">Mike Ross</name>
<affiliation><nlm:aff id="af2"><addr-line>Division of Nephrology</addr-line>
,<institution>Mount Sinai School of Medicine</institution>
,<country>New York</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name>
<affiliation><nlm:aff id="af3"><institution>Kirby Institute, University of New South Wales</institution>
,<addr-line>Sydney</addr-line>
,<country>Australia</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Morlat, Philippe" sort="Morlat, Philippe" uniqKey="Morlat P" first="Philippe" last="Morlat">Philippe Morlat</name>
<affiliation><nlm:aff id="af4"><institution>Université Bordeaux, INSERM U 897, CHU de Bordeaux</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fontas, Eric" sort="Fontas, Eric" uniqKey="Fontas E" first="Eric" last="Fontas">Eric Fontas</name>
<affiliation><nlm:aff id="af5"><addr-line>Nephrology Department, Public Health Department</addr-line>
,<institution>CHU Nice</institution>
,<country>France</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Smit, Colette" sort="Smit, Colette" uniqKey="Smit C" first="Colette" last="Smit">Colette Smit</name>
<affiliation><nlm:aff id="af6"><addr-line>Academic Medical Center, Division of Infectious Diseases</addr-line>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af7"><addr-line>Department of Global Health</addr-line>
,<institution>University of Amsterdam</institution>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af8"><institution>HIV Monitoring Foundation</institution>
,<addr-line>Amsterdam</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fux, Christoph A" sort="Fux, Christoph A" uniqKey="Fux C" first="Christoph A." last="Fux">Christoph A. Fux</name>
<affiliation><nlm:aff id="af9"><addr-line>Clinic for Infectious Diseases and Hospital Hygiene</addr-line>
,<institution>Kantonsspital Aarau</institution>
,<country>Switzerland</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hatleberg, Camilla I" sort="Hatleberg, Camilla I" uniqKey="Hatleberg C" first="Camilla I." last="Hatleberg">Camilla I. Hatleberg</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stéphane" last="De Wit">Stéphane De Wit</name>
<affiliation><nlm:aff id="af10"><addr-line>Department of Infectious Diseases</addr-line>
,<institution>CHU Saint-Pierre</institution>
,<addr-line>Brussels</addr-line>
,<country>Belgium</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name>
<affiliation><nlm:aff id="af11"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name>
<affiliation><nlm:aff id="af11"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of Infectious Diseases</title>
<idno type="ISSN">0022-1899</idno>
<idno type="eISSN">1537-6613</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><bold><italic>Background.</italic>
</bold>
While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)–positive individuals.</p>
<p><bold><italic>Methods.</italic>
</bold>
Individuals with ≥2 estimated glomerular filtration rate (eGFR) measurements after 1 February 2004 were followed until CVD, death, last visit plus 6 months, or 1 February 2015. CVD was defined as the occurrence of centrally validated myocardial infarction, stroke, invasive cardiovascular procedures, or sudden cardiac death.</p>
<p><bold><italic>Results.</italic>
</bold>
During a median follow-up duration of 8.0 years (interquartile range, 5.4–8.9 years) 1357 of 35 357 individuals developed CVD (incidence rate, 5.2 cases/1000 person-years [95% confidence interval {CI}, 5.0–5.5]). Confirmed baseline eGFR and CVD were closely related with 1.8% of individuals (95% CI, 1.6%–2.0%) with an eGFR > 90 mL/minute/1.73 m<sup>2</sup>
estimated to develop CVD at 5 years, increasing to 21.1% (95% CI, 6.6%–35.6%) among those with an eGFR ≤ 30 mL/minute/1.73 m<sup>2</sup>
. The strong univariate relationship between low current eGFR and CVD was primarily explained by increasing age in adjusted analyses, although all eGFRs ≤ 80 mL/minute/1.73 m<sup>2</sup>
remained associated with 30%–40% increased CVD rates, and particularly high CVD rates among individuals with an eGFR ≤ 30 mL/minute/1.73 m<sup>2</sup>
(incidence rate ratio, 3.08 [95% CI, 2.04–4.65]).</p>
<p><bold><italic>Conclusions.</italic>
</bold>
Among HIV-positive individuals in a large contemporary cohort, a strong relation between confirmed impaired eGFR and CVD was observed. This finding highlights the need for renal preventive measures and intensified monitoring for emerging CVD, particularly in older individuals with continuously low eGFRs.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Infect. Dis</journal-id>
<journal-id journal-id-type="publisher-id">jid</journal-id>
<journal-id journal-id-type="hwp">jinfdis</journal-id>
<journal-title-group><journal-title>The Journal of Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-1899</issn>
<issn pub-type="epub">1537-6613</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27485357</article-id>
<article-id pub-id-type="pmc">5034954</article-id>
<article-id pub-id-type="doi">10.1093/infdis/jiw342</article-id>
<article-id pub-id-type="publisher-id">jiw342</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Major Articles and Brief Reports</subject>
<subj-group subj-group-type="heading"><subject>HIV/AIDS</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ryom</surname>
<given-names>Lene</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lundgren</surname>
<given-names>Jens D.</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ross</surname>
<given-names>Mike</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kirk</surname>
<given-names>Ole</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Law</surname>
<given-names>Matthew</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Morlat</surname>
<given-names>Philippe</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fontas</surname>
<given-names>Eric</given-names>
</name>
<xref ref-type="aff" rid="af5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Smit</surname>
<given-names>Colette</given-names>
</name>
<xref ref-type="aff" rid="af6">6</xref>
<xref ref-type="aff" rid="af7">7</xref>
<xref ref-type="aff" rid="af8">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fux</surname>
<given-names>Christoph A.</given-names>
</name>
<xref ref-type="aff" rid="af9">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hatleberg</surname>
<given-names>Camilla I.</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>de Wit</surname>
<given-names>Stéphane</given-names>
</name>
<xref ref-type="aff" rid="af10">10</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sabin</surname>
<given-names>Caroline A.</given-names>
</name>
<xref ref-type="aff" rid="af11">11</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mocroft</surname>
<given-names>Amanda</given-names>
</name>
<xref ref-type="aff" rid="af11">11</xref>
</contrib>
<on-behalf-of>for the D:A:D Study Group</on-behalf-of>
<aff id="af1"><label>1</label>
<addr-line>Department of Infectious Diseases, CHIP, Section 2100</addr-line>
,<institution>Rigshospitalet, University of Copenhagen</institution>
,<country>Denmark</country>
</aff>
<aff id="af2"><label>2</label>
<addr-line>Division of Nephrology</addr-line>
,<institution>Mount Sinai School of Medicine</institution>
,<country>New York</country>
</aff>
<aff id="af3"><label>3</label>
<institution>Kirby Institute, University of New South Wales</institution>
,<addr-line>Sydney</addr-line>
,<country>Australia</country>
</aff>
<aff id="af4"><label>4</label>
<institution>Université Bordeaux, INSERM U 897, CHU de Bordeaux</institution>
</aff>
<aff id="af5"><label>5</label>
<addr-line>Nephrology Department, Public Health Department</addr-line>
,<institution>CHU Nice</institution>
,<country>France</country>
</aff>
<aff id="af6"><label>6</label>
<addr-line>Academic Medical Center, Division of Infectious Diseases</addr-line>
</aff>
<aff id="af7"><label>7</label>
<addr-line>Department of Global Health</addr-line>
,<institution>University of Amsterdam</institution>
</aff>
<aff id="af8"><label>8</label>
<institution>HIV Monitoring Foundation</institution>
,<addr-line>Amsterdam</addr-line>
,<country>The Netherlands</country>
</aff>
<aff id="af9"><label>9</label>
<addr-line>Clinic for Infectious Diseases and Hospital Hygiene</addr-line>
,<institution>Kantonsspital Aarau</institution>
,<country>Switzerland</country>
</aff>
<aff id="af10"><label>10</label>
<addr-line>Department of Infectious Diseases</addr-line>
,<institution>CHU Saint-Pierre</institution>
,<addr-line>Brussels</addr-line>
,<country>Belgium</country>
</aff>
<aff id="af11"><label>11</label>
<addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</aff>
</contrib-group>
<contrib-group><contrib contrib-type="collab"><collab>for the D:A:D Study Group</collab>
</contrib>
<contrib contrib-type="collab"><name><surname>El-Sadr</surname>
<given-names>W.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Calvo</surname>
<given-names>G.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Dabis</surname>
<given-names>F.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Kirk</surname>
<given-names>O.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Law</surname>
<given-names>M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Monforte</surname>
<given-names>A. d'Arminio</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Morfeldt</surname>
<given-names>L.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Pradier</surname>
<given-names>C.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Reiss</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Weber</surname>
<given-names>R.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>De Wit</surname>
<given-names>S.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Powderly</surname>
<given-names>B.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Shortman</surname>
<given-names>N.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Moecklinghoff</surname>
<given-names>C.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Reilly</surname>
<given-names>G.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Franquet</surname>
<given-names>X.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Hatleberg</surname>
<given-names>C.I.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Ryom</surname>
<given-names>L.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Sabin</surname>
<given-names>C.A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Kamara</surname>
<given-names>D.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Smith</surname>
<given-names>CJ.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Phillips</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Mocroft</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Bojesen</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Grevsen</surname>
<given-names>A.L.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Matthews</surname>
<given-names>C.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Raben</surname>
<given-names>D.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Lundgren</surname>
<given-names>J.D.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Lind-Thomsen</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Brandt</surname>
<given-names>R. Salbøl</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Hillebreght</surname>
<given-names>M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Zaheri</surname>
<given-names>S.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Wit</surname>
<given-names>F.W.N.M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Schöni-Affolter</surname>
<given-names>F.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Travelli</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Fanti</surname>
<given-names>I.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Leleux</surname>
<given-names>O.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Thulin</surname>
<given-names>E.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Sundström</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Bartsch</surname>
<given-names>G.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Thompsen</surname>
<given-names>G.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Delforge</surname>
<given-names>M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Fontas</surname>
<given-names>E.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Caissotti</surname>
<given-names>C.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Dollet</surname>
<given-names>K.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Mateu</surname>
<given-names>S.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Torres</surname>
<given-names>F.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Puhr</surname>
<given-names>R.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Kristensen</surname>
<given-names>D.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Sjøl</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Meidahl</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Helweg-Larsen</surname>
<given-names>J.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Iversen</surname>
<given-names>J. Schmidt</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Ryom</surname>
<given-names>L.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Mocroft</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Kirk</surname>
<given-names>O.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Reiss</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Smit</surname>
<given-names>C.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Ross</surname>
<given-names>M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Fux</surname>
<given-names>C.A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Morlat</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Fontas</surname>
<given-names>E.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Kamara</surname>
<given-names>D.A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Smith</surname>
<given-names>C.J.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Lundgren</surname>
<given-names>J.D.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Smith</surname>
<given-names>C.J.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Ryom</surname>
<given-names>L.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Hatleberg</surname>
<given-names>C. I.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Phillips</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Weber</surname>
<given-names>R.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Morlat</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Pradier</surname>
<given-names>C.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Reiss</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Wit</surname>
<given-names>F.W.N.M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Friis-Møller</surname>
<given-names>N.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Kowalska</surname>
<given-names>J.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Lundgren</surname>
<given-names>J.D.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Sabin</surname>
<given-names>C.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Law</surname>
<given-names>M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Monforte</surname>
<given-names>A. d'Arminio</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Dabis</surname>
<given-names>F.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Bonnet</surname>
<given-names>F.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Reiss</surname>
<given-names>P.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Wit</surname>
<given-names>F.W.N.M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Smith</surname>
<given-names>CJ.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Kamara</surname>
<given-names>D.A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Bohlius</surname>
<given-names>J.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Bower</surname>
<given-names>M.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Fätkenheuer</surname>
<given-names>G.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Grulich</surname>
<given-names>A.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Ryom</surname>
<given-names>L.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Hatleberg</surname>
<given-names>C.I.</given-names>
</name>
</contrib>
<contrib contrib-type="collab"><name><surname>Lundgren</surname>
<given-names>J.D.</given-names>
</name>
</contrib>
</contrib-group>
<author-notes><fn id="AN1" fn-type="con"><p>This project was presented in part at CROI, 23–26 February 2015, Seattle, abstract ID: 2099268.</p>
</fn>
<corresp>Correspondence: L. Ryom, Department of Infectious Diseases, CHIP, Section 2100, Rigshospitalet, Finsencentret, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen O, Denmark (<email>lene.ryom.nielsen@regionh.dk</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>15</day>
<month>10</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>02</day>
<month>8</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>15</day>
<month>10</month>
<year>2017</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and
0 days and was based on the . </pmc-comment>
<volume>214</volume>
<issue>8</issue>
<fpage>1212</fpage>
<lpage>1220</lpage>
<history><date date-type="received"><day>2</day>
<month>6</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>26</day>
<month>7</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail <email>journals.permissions@oup.com</email>
.</copyright-statement>
<copyright-year>2016</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:href="jiw342.pdf"></self-uri>
<abstract><p><bold><italic>Background.</italic>
</bold>
While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)–positive individuals.</p>
<p><bold><italic>Methods.</italic>
</bold>
Individuals with ≥2 estimated glomerular filtration rate (eGFR) measurements after 1 February 2004 were followed until CVD, death, last visit plus 6 months, or 1 February 2015. CVD was defined as the occurrence of centrally validated myocardial infarction, stroke, invasive cardiovascular procedures, or sudden cardiac death.</p>
<p><bold><italic>Results.</italic>
</bold>
During a median follow-up duration of 8.0 years (interquartile range, 5.4–8.9 years) 1357 of 35 357 individuals developed CVD (incidence rate, 5.2 cases/1000 person-years [95% confidence interval {CI}, 5.0–5.5]). Confirmed baseline eGFR and CVD were closely related with 1.8% of individuals (95% CI, 1.6%–2.0%) with an eGFR > 90 mL/minute/1.73 m<sup>2</sup>
estimated to develop CVD at 5 years, increasing to 21.1% (95% CI, 6.6%–35.6%) among those with an eGFR ≤ 30 mL/minute/1.73 m<sup>2</sup>
. The strong univariate relationship between low current eGFR and CVD was primarily explained by increasing age in adjusted analyses, although all eGFRs ≤ 80 mL/minute/1.73 m<sup>2</sup>
remained associated with 30%–40% increased CVD rates, and particularly high CVD rates among individuals with an eGFR ≤ 30 mL/minute/1.73 m<sup>2</sup>
(incidence rate ratio, 3.08 [95% CI, 2.04–4.65]).</p>
<p><bold><italic>Conclusions.</italic>
</bold>
Among HIV-positive individuals in a large contemporary cohort, a strong relation between confirmed impaired eGFR and CVD was observed. This finding highlights the need for renal preventive measures and intensified monitoring for emerging CVD, particularly in older individuals with continuously low eGFRs.</p>
</abstract>
<kwd-group><kwd>eGFR</kwd>
<kwd>renal impairment</kwd>
<kwd>kidney disease</kwd>
<kwd>cardiovascular disease</kwd>
<kwd>myocardial infarction</kwd>
<kwd>stroke</kwd>
<kwd>invasive cardiovascular procedures</kwd>
<kwd>sudden cardiac death</kwd>
<kwd>HIV</kwd>
</kwd-group>
<funding-group><award-group id="funding-1"><funding-source><institution-wrap><institution>Highly Active Antiretroviral Therapy Oversight Committee</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-2"><funding-source><institution-wrap><institution>European Agency for the Evaluation of Medicinal Products</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-3"><funding-source><institution-wrap><institution>Food and Drug Administration</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-4"><funding-source><institution-wrap><institution>AbbVie</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-5"><funding-source><institution-wrap><institution>Bristol-Myers Squibb</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-6"><funding-source><institution-wrap><institution>Gilead Sciences</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-7"><funding-source><institution-wrap><institution>ViiV Healthcare</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-8"><funding-source><institution-wrap><institution>Merck</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-9"><funding-source><institution-wrap><institution>Janssen Pharmaceuticals</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-10"><funding-source><institution-wrap><institution>Danish National Research Foundation</institution>
</institution-wrap>
</funding-source>
<award-id>DNRF126</award-id>
</award-group>
<award-group id="funding-11"><funding-source><institution-wrap><institution>Dutch Ministry of Health, Welfare, and Sport</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-12"><funding-source><institution-wrap><institution>Center for Infectious Disease Control, National Institute for Public Health and the Environment, to Stichting HIV Monitoring (via a grant to ATHENA)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-13"><funding-source><institution-wrap><institution>Agence nationale de recherches sur le sida et les hépatites virales (Action Coordonnée no. 7, Cohortes; grant</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-14"><funding-source><institution-wrap><institution>Aquitaine cohort</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-15"><funding-source><institution-wrap><institution>Asia Pacific HIV Observational Database</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-16"><funding-source><institution-wrap><institution>Foundation for AIDS Research</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-17"><funding-source><institution-wrap><institution>amfAR (to the Australian HIV Observational Database [AHOD])</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-18"><funding-source><institution-wrap><institution>National Institute of Allergy and Infectious Diseases (NIAID)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-19"><funding-source><institution-wrap><institution>National Institutes of Health</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-20"><funding-source><institution-wrap><institution>NIH</institution>
</institution-wrap>
</funding-source>
<award-id>U01-AI069907</award-id>
<award-id>5U01AI042170-10</award-id>
<award-id>5U01AI046362-03</award-id>
</award-group>
<award-group id="funding-21"><funding-source><institution-wrap><institution>Terry Beirn Community Programs</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-22"><funding-source><institution-wrap><institution>Clinical Research on AIDS</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-23"><funding-source><institution-wrap><institution>Merck Sharp and Dohme (unconditional grant to the AHOD)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-24"><funding-source><institution-wrap><institution>Gilead Sciences (unconditional grant to the AHOD)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-25"><funding-source><institution-wrap><institution>Bristol-Myers Squibb (unconditional grant to the AHOD</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-26"><funding-source><institution-wrap><institution>Boehringer Ingelheim (unconditional grant to the AHOD)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-27"><funding-source><institution-wrap><institution>Janssen-Cilag (unconditional grant to the AHOD)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-28"><funding-source><institution-wrap><institution>ViiV Healthcare (unconditional grant to the AHOD)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-29"><funding-source><institution-wrap><institution>Australian Government Department of Health and Ageing</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-30"><funding-source><institution-wrap><institution>Fondo de Investigación Sanitaria</institution>
</institution-wrap>
</funding-source>
<award-id>FIS 99/0887</award-id>
</award-group>
<award-group id="funding-31"><funding-source><institution-wrap><institution>Barcelona Antiretroviral Surveillance Study [BASS]</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-32"><funding-source><institution-wrap><institution>Fundación para la Investigación y la Prevención del SIDA en Espanã</institution>
</institution-wrap>
</funding-source>
<award-id>FIPSE 3171/00</award-id>
</award-group>
<award-group id="funding-33"><funding-source><institution-wrap><institution>NIAID</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-34"><funding-source><institution-wrap><institution>NIH</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-35"><funding-source><institution-wrap><institution>European Union's Seventh Framework Programme</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-36"><funding-source><institution-wrap><institution>EuroCoord</institution>
</institution-wrap>
</funding-source>
<award-id>260694</award-id>
</award-group>
<award-group id="funding-37"><funding-source><institution-wrap><institution>EuroSIDA</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-38"><funding-source><institution-wrap><institution>Janssen R&D (unrestricted grant to the EuroSIDA study)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-39"><funding-source><institution-wrap><institution>Merck (unrestricted grant to the EuroSIDA study)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-40"><funding-source><institution-wrap><institution>Pfizer (unrestricted grant to the EuroSIDA study and unrestricted educational grant to the Italian Cohort Naive to Antiretrovirals [ICONA] Foundation)</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-41"><funding-source><institution-wrap><institution>GlaxoSmithKline (unrestricted grant to the EuroSIDA study); the Swiss National Science Foundation</institution>
</institution-wrap>
</funding-source>
<award-id>108787</award-id>
</award-group>
<award-group id="funding-42"><funding-source><institution-wrap><institution>EuroSIDA</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-43"><funding-source><institution-wrap><institution>AbbVie</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-44"><funding-source><institution-wrap><institution>ICONA Foundation</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-45"><funding-source><institution-wrap><institution>Gilead Sciences</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-46"><funding-source><institution-wrap><institution>ICONA Foundation</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-47"><funding-source><institution-wrap><institution>anssen Pharmaceuticals</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-48"><funding-source><institution-wrap><institution>ICONA Foundation</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-49"><funding-source><institution-wrap><institution>Swiss National Science Foundation</institution>
</institution-wrap>
</funding-source>
<award-id>148522</award-id>
</award-group>
<award-group id="funding-50"><funding-source><institution-wrap><institution>Swiss HIV Cohort Study, SHCS</institution>
</institution-wrap>
</funding-source>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>
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