AEGiS-15IAC: Renal disease in HIV infected subjects: The deleterious effect of smoking.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Renal disease in HIV infected subjects: The deleterious effect of smoking.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoPeB3274)

Miguez-Burbano MJ, Rodriguez A, Hadrigan S, Azor C, Shor-Posner G
University of Miami School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Disease Prevention, Miami, United States

Introduction: Although an exponential increase in renal disease in HIV patients is anticipated, the biological mechanisms and risk factors whereby renal disease develops are complex and incompletely defined.

METHODS: 534 HIV (+) subjects consecutively admitted to Jackson Memorial Hospital, Miami, Florida (2001-2002) were evaluated for renal disease and associated risk factors. Measurements included discharge diagnosis, clinical data, laboratory results, and responses to treatments.

RESULTS: 58 HIV infected patients were admitted with renal involvement to JMH, representing 11% of the admissions. The group included 36 men and 22 women. The mean age of the group was 42±9 and no significant differences in age or drug use were noted between Renal patients (Rps) and non-renal patients (NRps). Most patients with renal disease had AIDS, however, no significant differences in CD4 counts (105±14 vs. 140±9), viral load (229,706±58,984 vs. 257,175±29,982), nor in the number of years living with HIV were observed between Rps and NRps. In logistic regression, renal involvement was associated with African and Haitian race (OR=2.6, p=0.03; 2.7, p=0.05); and long-term smoking (>10 years) (OR=7 1.05-46.4; p=0.02). Furthermore, most women with renal disease were long-term smokers. On the other hand, smoking was not an important risk factor in the Haitian population. Conclusion These findings confirm the importance of renal disease as a cause of hospitalization among HIV infected subjects, suggesting that increased attention needs to be directed towards the underlying cause(s) of HIV-associated nephropathy. These compelling findings demonstrate the important risk of long-term smoking as a pathogenic factor of renal disease in HIV infected individuals. Further studies are necessary to identify the mechanism of tobacco induced renal dysfunction. Supported by the Florida Health Department.

Keywords: AEGIS, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, CD4 Lymphocyte Count, HIV Infections, Risk Factors, Viral Load, Kidney Diseases, Smoking, Anti-HIV Agents, HIV Seronegativity, AIDS-Associated Nephropathy, Logistic Models, Substance-Related Disorders, Florida, Haiti, Humans, Female, Male, immunology

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