Highly Active Antiretroviral Therapy and the Epidemic of HIV+ End-Stage Renal Disease

• DOI: 10.1681/asn.2005040340
• Publication Date: 2005-06-30T00:24:37Z
• Authors: Elissa J. Schwartz; Lynda A. Szczech; Michael J. Ross; Mary E. Klotman; Jonathan A. Winston; Paul E. Klotman
• Keywords: Acquired Immunodeficiency Syndrome; Time Factors; Black People; HIV Infections; Models, Theoretical; United States; 3. Good health; Black or African American; 03 medical and health sciences; 0302 clinical medicine; Antiretroviral Therapy, Highly Active; Disease Progression; Prevalence; Humans; Kidney Failure, Chronic; AIDS-Associated Nephropathy; Least-Squares Analysis; Forecasting

The rise in the number of patients with HIV-associated nephropathy and HIV-infection end-stage renal disease (HIV+ ESRD) continues to be a substantial concern for ESRD program. In order assess impact highly active antiretroviral therapy (HAART) on progression AIDS development project prevalence HIV+ through 2020, mathematical model dynamics infection population was developed. Epidemiologic data among black individuals United States were obtained since 1991 from Centers Disease Control Prevention US Renal Data System, respectively. constructed predict incorporating current rate growth prevalence. Two possible trends considered: linear exponential growth. likely effectiveness HAART slowing estimated best fit after 1995, when introduced. then used evaluate recent 2020. suggested that has reduced by 38%. projected an increase future as result individuals. This predicted even assuming 95% reduction ESRD. Despite potential benefit HAART, is expected expansion It concluded prevention should focus early treatment HIV-infected who have evidence nephropathy.