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. 2019 Jan-Dec:18:2325958218821963.
doi: 10.1177/2325958218821963.

Long Term Exposure to Tenofovir Disoproxil Fumarate-Containing Antiretroviral Therapy Is Associated with Renal Impairment in an African Cohort of HIV-Infected Adults

Oche O Agbaji  1   2 , Isaac O Abah  2   3 , Augustine O Ebonyi  2   4 , Zumnan M Gimba  1 , Esla E Abene  1 , Simji S Gomerep  1   2 , Kakjing D Falang  2   5 , Joseph Anejo-Okopi  2   6 , Patricia A Agaba  2   7 , Placid O Ugoagwu  2 , Emmanuel I Agaba  1 , Godwin E Imade  2   8 , Atiene S Sagay  2   8 , Prosper Okonkwo  9 , John A Idoko  1 , Phyllis J Kanki  10
Affiliations

Long Term Exposure to Tenofovir Disoproxil Fumarate-Containing Antiretroviral Therapy Is Associated with Renal Impairment in an African Cohort of HIV-Infected Adults

Oche O Agbaji et al. J Int Assoc Provid AIDS Care. 2019 Jan-Dec.

Abstract

Objectives and method: There are growing concerns of tenofovir disoproxil fumarate (TDF)-associated renal toxicity. We evaluated the effect of long-term TDF exposure on renal function in a cohort of HIV-1-infected Nigerians between 2006 and 2015. Multivariate logistic regression was used to identify predictors of renal impairment at different time over 144 weeks of antiretroviral therapy (ART).

Results: Data of 4897 patients, median age 42 years (interquartile range: 36-49), and 61% females were analyzed. The prevalence of renal impairment increased from 10% at week 24 to 45% at 144 weeks in TDF-exposed participants compared to an increase from 8% at 24 weeks to 14% at 144 weeks in TDF-unexposed participants. Tenofovir disoproxil fumarate exposure predicted the risk of renal impairment at 144 weeks of ART (odds ratio: 2.36; 95% confidence interval: 1.28-4.34).

Conclusion: Long-term exposure to TDF-based ART significantly increases the likelihood of renal impairment. The continued use of TDF-based regimen in our setting should be reviewed. We recommend the urgent introduction of tenofovir alafenamide-based regimen in the HIV treatment guidelines of Nigeria and other resource-limited countries.

Keywords: ART; HIV; Nigeria; renal impairment; tenofovir.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Prevalence of renal impairment*, overall, and by tenofovir exposure over 144 weeks of antiretroviral therapy. * denotes patient met 1 or more of the defined criteria for renal impairment based on eGFR <60 mL/min/1.73 m2 or a doubling of serum creatinine from baseline. TDF indicates tenofovir disoproxil fumarate.
See this image and copyright information in PMC

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