PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

A risk score for chronic kidney disease can inform choice of HIV medications

2015-03-31
(Press-News.org) Both traditional and HIV-related risk factors can predict the likelihood of developing chronic kidney disease (CKD), according to a study published this week in PLOS Medicine. In the study, Amanda Mocroft, of University College London, United Kingdom, and colleagues developed and validated a risk score model that can help inform choices among antiretroviral drugs for patients with HIV.

Antiretroviral therapy can help control HIV, extending the life expectancy of those with the virus. However, some antiretroviral drugs may be nephrotoxic (harmful to the kidney), increasing the risk of CKD. Mocroft and colleagues used clinical and demographic data from 17,954 HIV-positive individuals enrolled in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study to develop a CKD risk score model based on nine factors (age, intravenous drug use, hepatitis C co-infection, estimated glomerular filtration rate (a measure of kidney function), gender, nadir CD4 count (a measure of severity of immune system damage prior to treatment for HIV), hypertension, diabetes, and cardiovascular disease). They found that study participants with characteristics that resulted in a low risk score had a 1 in 393 chance of developing CKD in the following five years, while participants with medium and high risk scores had a 1 in 47 and 1 in 6 chance, respectively, of developing CKD. The researchers were also able to determine the added risk of using potentially nephrotoxic antiretroviral drugs.

For an additional patient to develop CKD within five years, the number of patients in the low risk group that would have to be treated with the antiretroviral drugs tenofovir, atazanavir/ritonavir, or another boosted (combined with ritonavir to increase blood levels) protease inhibitor (not including lopinavir/ritonavir) was 739. That "number needed to harm" (NNTH) was 88 and 9 in the medium and high risk groups, respectively. Treatment with unboosted atazanavir, or lopinavir/ritonavir added less potential harm, resulting in higher NNTH: 1702, 202, and 21 for the low, medium and high risk groups. The researchers validated this risk score using two independent HIV study groups, but note that they were not able to fully incorporate data on race, or include data on the presence of protein in urine (a common screening test for kidney injury) into the model.

The authors say this risk score "has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD, and to identify those at greatest risk of CKD." A tool for calculating risk using their model is available online http://hivpv.org/Home/Tools/ChronicKidneyDiseaseTool.aspx.

INFORMATION:

Funding: Data on Adverse Events (D:A:D) Study: The D:A:D study was supported by the Highly Active Antiretroviral Therapy Oversight Committee (HAARTOC) , a collaborative committee with representation from academic institutions, the European Agency for the Evaluation of Medicinal Products, the United States Food and Drug Administration, the patient community, and all pharmaceutical companies with licensed anti-HIV drugs in the European Union: AbbVie, Boehringer Ingelheim Pharmaceuticals Inc., Bristol-Myers Squibb, Gilead Sciences Inc., ViiV Healthcare, Merck & Co Inc., Pfizer Inc, F. HoffmanLaRoche Ltd and Janssen Pharmaceuticals. Supported also by a grant [grant number DNRF126] from the Danish National Research Foundation to CHIP, Supported by a grant [grant number CURE/97- 46486] from the Health Insurance Fund Council, Amstelveen, the Netherlands, to the AIDS Therapy Evaluation Project Netherlands (ATHENA); by a grant from the Agence Nationale de Recherches sur le SIDA [grant number Action Coordonnée no.7, Cohortes], to the Aquitaine Cohort; The Australian HIV Observational Database (AHOD) is funded as part of the Asia Pacific HIV Observational Database, a program of The Foundation for AIDS Research, amfAR, and is supported in part by a grant from the U.S. National Institutes of Health's National Institute of Allergy and Infectious Diseases (NIAID) [grant number U01-AI069907] and by unconditional grants from Merck Sharp & Dohme; Gilead Sciences; Bristol-Myers Squibb; Boehringer Ingelheim Pharmaceuticals Inc.; Roche; Pfizer; GlaxoSmithKline; Janssen Pharmaceuticals. The Kirby Institute is funded by The Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales.

By grants from the Fondo de Investigación Sanitaria [grant number FIS 99/0887] and Fundación para la Investigación y la Prevención del SIDA en Espanã [grant number FIPSE 3171/00], to the Barcelona Antiretroviral Surveillance Study (BASS); by the National Institute of Allergy and Infectious Diseases, National Institutes of Health [grants number 5U01AI042170-10 , 5U01AI046362-03], to the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA); by grants from the BIOMED 1 [grant number CT94- 1637] and BIOMED 2 [grant number CT97-2713] programs and the fifth framework program [grant number QLK2-2000-00773] of the European Commission and grants from Bristol-Myers Squibb, GlaxoSmithKline, Boehringer Ingelheim Pharmaceuticals Inc. and Roche, to the EuroSIDA study; by unrestricted educational grants of Abbott Laboratories, Bristol-Myers Squibb, Gilead Sciences Inc., GSK, Pfizer Inc., Janssen Pharmaceuticals to the Italian Cohort Naive to Antiretrovirals (The ICONA Foundation); and by a grant from the Swiss National Science Foundation, to the Swiss HIV Cohort Study (SHCS).

The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above. SMART/ESPRIT: These studies were funded by the National Institute of Allergy and Infectious Diseases, National Institutes of Health [grant numbers UM1-AI068641, U01-AI042170 and U01-AI46362 (SMART); U01-AI46957 and U01- AI068641 (ESPRIT)]. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: PM: honoraria or travel/ meeting expenses from Bristol-Myers Squibb, Gilead, Janssen-Cilag, Merck Sharp & Dohme-Chibret and ViiV Healthcare in the past five years. ML received unrestricted grants to my institution from Boehringer Ingelhiem, Gilead Sciences, Merck Sharp & Dohme, Bristol-Myers Squibb, Janssen-Cilag, ViiV HealthCare. CS has received funds for preparation of Educational Materials from Janssen, Gilead, BMS, ViiV HealthCare, support for attendance at Ad board and support to attend HIV conference from Gilead, funding to conduct study from BMS. OM has received honoraria as a speaker from Abbott and Gilead Sciences, serves on the board of Roche, and had expenses paid by Roche and Baxter for travel, accommodations, and meetings. OK has received honoraria, consultancy, lecture fees, and travel grants from Abbott Laboratories, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck Sharp & Dohme, Roche, and ViiV Healthcare, and has served/is serving on Advisory Boards for Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare. AM has received honoraria, consultancy, lecture fees, and travel grants from Gilead Sciences, Merck Sharp & Dohme, Boehringer Ingelheim, Pfizer and GSK.

Citation: Mocroft A, Lundgren JD, Ross M, Law M, Reiss P, Kirk O, et al. (2015) Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study. PLoS Med 12(3): e1001809. doi:10.1371/journal.pmed.1001809

Author Affiliations:

University College London, UNITED KINGDOM
University of Copenhagen, DENMARK
Mount Sinai School of Medicine, UNITED STATES
University of New South Wales, AUSTRALIA
University of Amsterdam, THE NETHERLANDS
University of Minnesota, UNITED STATES
Kantonsspital Aarau, SWITZERLAND
Centre Hospitalier Universitaire de Nice, FRANCE
Universite de Bordeaux, FRANCE
Royal Free London NHS Foundation Trust, UNITED KINGDOM

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001809

Contact: Amanda Mocroft
University College London Medical School
UNITED KINGDOM
+44 2077 940 0500 extension 33194
a.mocroft@ucl.ac.uk



ELSE PRESS RELEASES FROM THIS DATE:

Stereotypes persist that class and privilege determine intellect and success

2015-03-31
A meritocracy holds that if you work hard enough, you can succeed in life, regardless of race, religion, gender or social status. But a new study from UC Berkeley suggests that, despite egalitarian efforts to downplay class as a forecaster for intelligence and achievement, many people still believe their destiny is tied to their station in life. The UC Berkeley study looked specifically at attitudes in India to the Hindu caste system. It found that children and adults who were more influenced by caste were also more likely to believe that their own natural aptitude, academic ...

Montréal scientists get one step closer to finding how to repair damaged nerve cells

2015-03-31
Montréal, March 31, 2015 - A team of researchers at the IRCM led by Frédéric Charron, PhD, in collaboration with bioengineers at McGill University, uncovered a new kind of synergy in the development of the nervous system, which explains an important mechanism required for neural circuits to form properly. Their breakthrough, published today in the scientific journal PLoS Biology, could eventually help develop tools to repair nerve cells following injuries to the nervous system (such as the brain and spinal cord). Researchers in Dr. Charron's laboratory ...

Protein may improve liver regeneration

2015-03-31
(SACRAMENTO, Calif.) -- Researchers at UC Davis have illuminated an important distinction between mice and humans: how human livers heal. The difference centers on a protein called PPARα, which activates liver regeneration. Normally, mouse PPARα is far more active and efficient than the human form, allowing mice to quickly regenerate damaged livers. However, the research shows that protein fibroblast growth factor 21 (FGF21) can boost the regenerative effects of human PPARα. The findings suggest that the molecule could offer significant therapeutic benefits ...

In Alzheimer's mice, memory restored with cancer drug

In Alzheimers mice, memory restored with cancer drug
2015-03-31
Memory and as well as connections between brain cells were restored in mice with a model of Alzheimer's given an experimental cancer drug, Yale School of Medicine researchers reported in the journal Annals of Neurology. The drug, AZD05030, developed by Astra Zeneca proved disappointing in treating solid tumors but appears to block damage triggered during the formation of amyloid-beta plaques, a hallmark of Alzheimer's disease. The new study, funded by an innovative National Institutes of Health (NIH) program to test failed drugs on different diseases, has led to the launch ...

Picturing peanut contamination with near infrared hyperspectral imaging

2015-03-31
Study the label of almost any food product and you're likely to see the rather vague warning "May contain peanuts" somewhere on there, unless of course it's a product that definitely does contain peanuts. As now revealed in a paper in the latest issue of JNIRS--Journal of Near Infrared Spectroscopy, these warnings of peanut contamination could soon lose much of their uncertainty, thanks to a novel form of near infrared (NIR) spectroscopy known as NIR hyperspectral imaging (HSI). Any food product may contain traces of peanut if it is made with powdered foodstuffs like ...

'Religiously integrated' psychotherapy is effective for depression

2015-03-31
March 31, 2015 - For chronically ill patients with major depression, an approach to cognitive-behavioral therapy (CBT) that incorporates patients' religious beliefs is at least as effective as conventional CBT, suggests a study in the April issue of The Journal of Nervous and Mental Disease. The journal is published by Wolters Kluwer. "Integrating religious clients' beliefs into CBT does not appear to significantly reduce its effectiveness, especially in religious clients," write Dr Harold Koenig of Duke University Medical Center, Durham, N.C., and colleagues. They ...

Study: Phone counseling reduces pain, disability after back surgery

2015-03-31
Research by Johns Hopkins scientists suggests that having a short series of phone conversations with trained counselors can substantially boost recovery and reduce pain in patients after spinal surgery. The phone calls, designed to enrich standard pre- and post-operative care by reinforcing the value of sticking with physical therapy and back-strengthening exercise regimens, are a relatively inexpensive and simple intervention that can maximize surgical outcomes for the hundreds of thousands of Americans who undergo spinal surgeries every year, the investigators say. A ...

Premature aging of stem cell telomeres, not inflammation, linked to emphysema

2015-03-31
Lung diseases like emphysema and pulmonary fibrosis are common among people with malfunctioning telomeres, the "caps" or ends of chromosomes. Now, researchers from Johns Hopkins say they have discovered what goes wrong and why. Mary Armanios, M.D., an associate professor of oncology at the Johns Hopkins University School of Medicine., and her colleagues report that some stem cells vital to lung cell oxygenation undergo premature aging -- and stop dividing and proliferating -- when their telomeres are defective. The stem cells are those in the alveoli, the tiny air exchange ...

Significant reduction seen in fatal car crashes after an increase in alcohol taxes

2015-03-31
Increasing state alcohol taxes could prevent thousands of deaths a year from car crashes, say University of Florida Health researchers, who found alcohol-related motor vehicle crashes decreased after taxes on beer, wine and spirits went up in Illinois. A team of UF Health researchers discovered that fatal alcohol-related car crashes in Illinois declined 26 percent after a 2009 increase in alcohol tax. The decrease was even more marked for young people, at 37 percent. The reduction was similar for crashes involving alcohol-impaired drivers and extremely drunken drivers, ...

Soil organic matter susceptible to climate change

2015-03-31
Soil organic matter, long thought to be a semi-permanent storehouse for ancient carbon, may be much more vulnerable to climate change than previously thought. Plants direct between 40 percent and 60 percent of photosynthetically fixed carbon to their roots and much of this carbon is secreted and then taken up by root-associated soil microorganisms. Elevated carbon dioxide (CO2) concentrations in the atmosphere are projected to increase the quantity and alter the composition of root secretions released into the soil. In new research in the March 30 edition of the journal, ...

LAST 30 PRESS RELEASES:

Pink skies

Monkeys are world’s best yodellers - new research

Key differences between visual- and memory-led Alzheimer’s discovered

% weight loss targets in obesity management – is this the wrong objective?

An app can change how you see yourself at work

NYC speed cameras take six months to change driver behavior, effects vary by neighborhood, new study reveals

New research shows that propaganda is on the rise in China

Even the richest Americans face shorter lifespans than their European counterparts, study finds

Novel genes linked to rare childhood diarrhea

New computer model reveals how Bronze Age Scandinavians could have crossed the sea

Novel point-of-care technology delivers accurate HIV results in minutes

Researchers reveal key brain differences to explain why Ritalin helps improve focus in some more than others

Study finds nearly five-fold increase in hospitalizations for common cause of stroke

Study reveals how alcohol abuse damages cognition

Medicinal cannabis is linked to long-term benefits in health-related quality of life

Microplastics detected in cat placentas and fetuses during early pregnancy

Ancient amphibians as big as alligators died in mass mortality event in Triassic Wyoming

Scientists uncover the first clear evidence of air sacs in the fossilized bones of alvarezsaurian dinosaurs: the "hollow bones" which help modern day birds to fly

Alcohol makes male flies sexy

TB patients globally often incur "catastrophic costs" of up to $11,329 USD, despite many countries offering free treatment, with predominant drivers of cost being hospitalization and loss of income

Study links teen girls’ screen time to sleep disruptions and depression

Scientists unveil starfish-inspired wearable tech for heart monitoring

Footprints reveal prehistoric Scottish lagoons were stomping grounds for giant Jurassic dinosaurs

AI effectively predicts dementia risk in American Indian/Alaska Native elders

First guideline on newborn screening for cystic fibrosis calls for changes in practice to improve outcomes

Existing international law can help secure peace and security in outer space, study shows

Pinning down the process of West Nile virus transmission

UTA-backed research tackles health challenges across ages

In pancreatic cancer, a race against time

Targeting FGFR2 may prevent or delay some KRAS-mutated pancreatic cancers

[Press-News.org] A risk score for chronic kidney disease can inform choice of HIV medications