Prevalence of HIV infection in dialyzed patients: results of a national multicentric study

In order to determine the prevalence of HIV infection in french patients wi th end-stage renal disease (ESRD) on maintenance dialysis therapy, question naire forms were mailed out in february 1997 to the heads of the 260 dialys is facilities. We documented number of patients on maintenance dialysis the rapy (hemo and peritoneal dialysis) and for HIV infected dialysis patients: age, gender, cause and duration of ESRD, known duration of HIV infection, risk factors for HIV infection, HBV and/or HCV infection, presence of clini cal acquired immunodeficiency syndrome (AIDS), total CD4 count and treatmen t with antiretroviral agents. Questionnaire forms were returned from 98% of the dialysis facilities. As o f february 1997 some 22 707 patients with ESRD were treated by renal replac ement therapy, 19 947 by hemodialysis (HD) and 2760 by peritoneal dialysis (PD). 82 patients with ESRD and HIV infection were reported corresponding t o 0.36% prevalence rate of all patients undergoing dialysis at the time spe cified. The 82 study subjects with ESRD and HIV infection received hemodialysis (79 patients) or peritoneal dialysis (3 patients) in 42 facilities. Forty seve n patients were treated in Paris and suburbs and 9 in our own center. All 8 2 patients comprised 63% men and 47% women which included patients coming f rom Africa (37%), Caribbean and Oceania (28%), Europe (35%) of a mean age o f 41.8 years. Modes of transmission were homo-bisexuals 15%, heterosexuals 31%, intravenous drug abusers 17%, blood transfusion 17% and unknown 20%. T he mean duration of HIV infection was 96 months (range 12-168 months) and t he mean duration of ESRD was 58 months (range 1-235 months). HIV associated nephropathy was established in 31%. AIDS was diagnosed in 25 patients. Sev enty one percent of the patients were receiving an antiretroviral drug (tri therapy in 25% of cases). In conclusion HIV prevalence rate among French dialysis patients is low and focused in Paris and oversea, Sexual transmission is the most important HI V contamination but blood transfusion transmission remains greater than in general HIV population. Survival has improved compared with the survival ra te reported in the 1980s.