Ascertainment and verification of end-stage renal disease and end-stage liver disease in the north american AIDS cohort collaboration on research and design

Mari M Kitahata; Daniel R Drozd; Heidi M Crane; Stephen E Van Rompaey; Keri N Althoff; Stephen J Gange; Marina B Klein; Gregory M Lucas; Alison G Abraham; Vincent Lo Re 3rd; Justin McReynolds; William B Lober; Adell Mendes; Sharada P Modur; Yuezhou Jing; Elizabeth J Morton; Margaret A Griffith; Aimee M Freeman; Richard D Moore

doi:10.1155/2015/923194

Ascertainment and verification of end-stage renal disease and end-stage liver disease in the north american AIDS cohort collaboration on research and design

AIDS Res Treat. 2015:2015:923194. doi: 10.1155/2015/923194. Epub 2015 Feb 19.

Authors

Mari M Kitahata¹, Daniel R Drozd¹, Heidi M Crane¹, Stephen E Van Rompaey², Keri N Althoff³, Stephen J Gange³, Marina B Klein⁴, Gregory M Lucas⁵, Alison G Abraham³, Vincent Lo Re 3rd⁶, Justin McReynolds⁷, William B Lober⁸, Adell Mendes³, Sharada P Modur³, Yuezhou Jing³, Elizabeth J Morton², Margaret A Griffith², Aimee M Freeman³, Richard D Moore⁹

Affiliations

¹ Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA ; Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
² Center for AIDS Research, University of Washington, Seattle, WA 98104, USA.
³ Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
⁴ Division of Infectious Diseases Chronic Viral Illness Service, Department of Medicine, McGill University, Montreal, QC, Canada.
⁵ Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
⁶ Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia VA Medical Center, Philadelphia, PA 19104, USA.
⁷ Medical Education and Biomedical Informatics, School of Medicine, University of Washington, Seattle, WA 98109, USA.
⁸ Medical Education and Biomedical Informatics, School of Medicine, University of Washington, Seattle, WA 98109, USA ; Biobehavioral Nursing and Health Systems, Department of Nursing, University of Washington, Seattle, WA 98195, USA.
⁹ Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA ; Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.

Abstract

The burden of HIV disease has shifted from traditional AIDS-defining illnesses to serious non-AIDS-defining comorbid conditions. Research aimed at improving HIV-related comorbid disease outcomes requires well-defined, verified clinical endpoints. We developed methods to ascertain and verify end-stage renal disease (ESRD) and end-stage liver disease (ESLD) and validated screening algorithms within the largest HIV cohort collaboration in North America (NA-ACCORD). Individuals who screened positive among all participants in twelve cohorts enrolled between January 1996 and December 2009 underwent medical record review to verify incident ESRD or ESLD using standardized protocols. We randomly sampled 6% of contributing cohorts to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ESLD and ESRD screening algorithms in a validation subcohort. Among 43,433 patients screened for ESRD, 822 screened positive of which 620 met clinical criteria for ESRD. The algorithm had 100% sensitivity, 99% specificity, 82% PPV, and 100% NPV for ESRD. Among 41,463 patients screened for ESLD, 2,024 screened positive of which 645 met diagnostic criteria for ESLD. The algorithm had 100% sensitivity, 95% specificity, 27% PPV, and 100% NPV for ESLD. Our methods proved robust for ascertainment of ESRD and ESLD in persons infected with HIV.

Abstract

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