Comorbidities and their impact on mortality in HCV and HCV-HIV-coinfected persons on dialysis

Aim: To determine the rates of non-human immunodeficiency virus (HIV)-related comorbidities and their impact on survival in hepatitis C virus (HCV) and HCV-HIV coinfected persons oil dialysis. Methods: We identified HCV-infected subjects and diagnoses of medical and psychiatric comorbidities in the United States Renal Data System using ICD-9 codes. Logistic regression was used to determine the odds of comorbidities and predictors of mortality. Results: We identified 5310 HCV-infected and 427 HCV-HIV-coinfected subjects. The latter were younger, more likely to be male, black race, and had a lower body mass index. After adjusting for age, race and sex we found that coronary artery disease (CAD), diabetes mellitus (DM) as primary cause of renal failure and cirrhosis were less frequently diagnosed in the HCV- HIV-coinfected subjects, whereas hepatitis B, washing, drug and alcohol abuse, and dependence were more frequently diagnosed. Increasing age. CAD, stroke, DM. cirrhosis, wasting, cancer, and drug abuse and dependence were associated with higher odds of death in the HCV monoinfected subjects, whereas cirrhosis, wasting, and smoking were the only such factors in the HCV-HIV-coinfected subjects. Conclusions: The frequency and patterns of comorbidities and predictors of death differ in HCV-monoinfected and HCV- HIV-coinfected persons on dialysis. These differences should be taken into account when designing future interventions.