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. 2019 Jun 6;16(1):12.
doi: 10.1186/s12981-019-0227-1.

Tenofovir-associated kidney disease in Africans: a systematic review

Takudzwa J Mtisi  1 , Chiratidzo E Ndhlovu  2 , Chiedza C Maponga  3 , Gene D Morse  4
Affiliations

Tenofovir-associated kidney disease in Africans: a systematic review

Takudzwa J Mtisi et al. AIDS Res Ther. .

Abstract

Background: Data on chronic kidney disease development in HIV infection is important towards building a comprehensive knowledge of HIV, ageing and polypharmacy in Africa. Several previous studies on tenofovir-associated kidney disease in Africa have shown conflicting results. This review summarises what is known about the development of kidney disease in HIV-positive African patients on tenofovir disoproxil fumarate (TDF)-containing ART. We set out to document the occurrence of kidney disease in HIV-positive Africans on TDF-containing ART in population-based studies and to evaluate the renal safety of TDF in Africans.

Methods: We conducted a systemic review using published studies which were identified through a computerized search of original research using the Medline/PubMed database, EMBASE, EBM Reviews, Proquest Google Scholar and Global Health reported from inception until 5 October 2017. Two reviewers independently abstracted the data and performed quality assessment of the included studies. We screened 595 articles and included 31 in the qualitative analysis performed.

Results: A total of 106 406 patients (of whom 66,681 were on Tenofovir) were involved in these 31 studies with sample sizes ranging from 30 to 62,230. Duration on tenofovir-containing ART ranged from those initiating ART at baseline to those who received TDF for up to 9 years. All but one of the studies involved only patients 16 years and older. The studies had differing definitions of kidney dysfunction and were of variable study design quality. The documented outcomes had substantial discrepancies across the studies, most likely due to methodological differences, study size and disparate outcome definitions.

Conclusions: Our review identified studies in Africans reporting statistically significant renal function decline associated with TDF use but the clinical significance of this effect was not enough to contraindicate its continued use in ART regimens. Consistent with studies in other populations, patients are at greater risk if they have pre-existing renal disease and are more advanced in age. More research is needed on paediatric populations under 16 years of age. Trial registration This review was registered on Prospero (registration number CRD42018078717).

Keywords: Africans; Renal; Tenofovir.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Literature search results
Fig. 2
Fig. 2
African countries reporting renal outcomes of HIV positive patients on a Tenofovir-containing regimen
See this image and copyright information in PMC

References

    1. Wishart DS, Knox C, Guo AC, Cheng D, Shrivastava S, Tzur D, et al. DrugBank: a knowledgebase for drugs, drug actions and drug targets. Nucleic Acids Res. 2008;36(Database issue):D901–D906. doi: 10.1093/nar/gkm958. - DOI - PMC - PubMed
    1. Knox C, Law V, Jewison T, Liu P, Ly S, Frolkis A, et al. DrugBank 3.0: a comprehensive resource for ‘omics’ research on drugs. Nucleic Acids Res. 2011;39(Database issue):D1035–D1041. doi: 10.1093/nar/gkq1126. - DOI - PMC - PubMed
    1. da Rocha IM, Gasparotto AS, Lazzaretti RK, Notti RK, Sprinz E, Mattevi VS. Polymorphisms associated with renal adverse effects of antiretroviral therapy in a Southern Brazilian HIV cohort. Pharmacogenet Genom. 2015;25(11):541–547. - PubMed
    1. Kohler JJ, Hosseini SH, Green E, Abuin A, Ludaway T, Russ R, et al. Tenofovir renal proximal tubular toxicity is regulated By OAT1 and MRP4 transporters. Lab Invest. 2011;91(6):852–858. doi: 10.1038/labinvest.2011.48. - DOI - PMC - PubMed
    1. Pushpakom SP, Liptrott NJ, Rodríguez-Nóvoa S, Labarga P, Soriano V, Albalater M, et al. Genetic variants of ABCC10, a novel tenofovir transporter, are associated with kidney tubular dysfunction. J Infect Dis. 2011;204(1):145–153. doi: 10.1093/infdis/jir215. - DOI - PMC - PubMed

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