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AIDS Research and Treatment
Volume 2015 (2015), Article ID 923194, 11 pages
http://dx.doi.org/10.1155/2015/923194
Research Article

Ascertainment and Verification of End-Stage Renal Disease and End-Stage Liver Disease in the North American AIDS Cohort Collaboration on Research and Design

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

Received 15 December 2014; Accepted 16 January 2015

Academic Editor: Glenda Gray

Copyright © 2015 Mari M. Kitahata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.