238254 Prevalence of HIV-infected patients with end-stage renal disease (ESRD) in United States renal disease (USRD) program, 1995-2007

Monday, October 31, 2011

Dmitry Vishniakov, MD, MPH , Epidemiology and Biostatistics, GWU SPHHS, Washington, DC
Paul Eggers, PhD , National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
Paul Kimmel, MD , National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
Background: Widespread use of highly active antiretroviral therapy has transformed HIV from a fatal diagnosis to chronic condition and kidney diseases have become significant contributor to morbidity of HIV-infected patients. The main goal of our study was to determine the point prevalence and describe trends of HIV-infected patients with ESRD.

Methods: A retrospective cohort study of 22,658 HIV-infected patients with ESRD was conducted. Patients were identified using (1) the CMS Medical Evidence Form where HIV was listed as a primary cause of renal failure and/or (2) Medicare billing data where persons had at least one hospitalization or two outpatient encounters with an HIV/AIDS diagnosis.

Results: Analysis revealed that prevalent HIV/AIDS cases increased in a linear pattern from 1971 cases to 6741 cases and prevalence increased from 7 to 12 HIV-infected per 1000 ESRD population from 1995 to 2007 respectively. The modal age group (68.2%) in 1995 was among patients 25-44 years of age, in 2007 patients 45-64 years of age became the largest age group (54.5%). Females accounted for 22.9% and 28.2% of HIV ESRD patients in 1995 and 2007 respectively. The highest number of cases was among black patients (85% and 82.1% in 1995 and 2007 years respectively).

Conclusions: Several main trends of HIV-infection in the ESRD population were identified durinng the study period: constant increase of prevalent cases, aging of HIV-infected population, increased number of women, and consistently higher prevalence among blacks. These findings suggest that HIV remains a significant problem in the ESRD population.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
Identify prevalence of HIV-infected patients with end-stage renal disease Describe trends of HIV infected patients with ESRD in USRDS program

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have done all the data analysis and wrote an abstract
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.