Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Nov;79(5):454-461.
doi: 10.1016/j.jinf.2019.08.006. Epub 2019 Aug 8.

Long term renal function in Asian HIV-1 infected adults receiving tenofovir disoproxil fumarate without protease inhibitors

Geoffroy Liegeon  1 , Linda Harrison  2 , Anouar Nechba  3 , Guttiga Halue  4 , Sukit Banchongkit  5 , Ampaipith Nilmanat  6 , Naruepon Yutthakasemsunt  7 , Panita Pathipvanich  8 , Suchart Thongpaen  9 , Rittha Lertkoonalak  10 , Thomas Althaus  11 , Marc Lallemant  12 , Jean-Yves Mary  13 , Gonzague Jourdain  14
Affiliations
Comparative Study

Long term renal function in Asian HIV-1 infected adults receiving tenofovir disoproxil fumarate without protease inhibitors

Geoffroy Liegeon et al. J Infect. 2019 Nov.

Abstract

Objectives: The risk of kidney dysfunction on the WHO recommended first line regimens containing tenofovir disoproxil fumarate (TDF) without protease inhibitors (PI) remains unclear in Asian patients, especially those with low body weight.

Methods: Using data collected in a multicenter clinical trial in Thailand and proportional hazard regression models, we compared the risk of a >25% estimated glomerular filtration rate (eGFR) reduction in HIV naïve patients initiating TDF or zidovudine (AZT) containing non-PI regimen.

Results: Of 640 patients included in the analysis, 461 (72%) received a TDF-containing regimen for a median 6.7 years and 179 (28%) an AZT-containing regimen for 6.5 years. The risk of a >25% eGFR reduction was not associated with treatment (HR 1.11, 95% CI 0.84-1.47, P = 0.46). In multivariate analysis, the risk of >25% eGFR reduction form baseline was associated with body weight at baseline (HR 2.12, 95% CI 1.48-3.02 for <48 kg patients and HR 1.64, 95% CI 1.20-2.25 for 48-59.9 kg patients, compared to those with >60 kg, P < 0.001) and hypertension (HR 4.03, 95% CI 2.0-8.0, P < 0.001). The effect of baseline weight on >25% eGFR reduction did not significantly vary with treatment (P = 0.27).

Conclusions: The risk of eGFR reduction was not higher on TDF- versus AZT-based non-PI regimens. Although the risk of eGFR reduction was greater for patients of lower body weight, this risk was not significantly increased by TDF.

Keywords: Body weight; HIV; Kidney; Protease inhibitors (PI); Tenofovir disoproxil fumarate (TDF); Thailand; eGFR.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Patient disposition.
Figure 2.
Figure 2.
Kaplan-Meier curves for time from baseline to >25% reduction in eGFR according baseline body weight in each treatment group.
See this image and copyright information in PMC

References

    1. WHO | Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection [Internet]. WHO; [cited 2017 Aug 29]. Available from: http://www.who.int/hiv/pub/arv/arv-2016/en/
    1. European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017. August;67(2):370–98. - PubMed
    1. Lucas GM, Ross MJ, Stock PG, Shlipak MG, Wyatt CM, Gupta SK, et al. Clinical Practice Guideline for the Management of Chronic Kidney Disease in Patients Infected With HIV: 2014 Update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014. November 1;59(9):e96–138. - PMC - PubMed
    1. Cooper RD, Wiebe N, Smith N, Keiser P, Naicker S, Tonelli M. Systematic review and meta-analysis: renal safety of tenofovir disoproxil fumarate in HIV-infected patients. Clin Infect Dis. 2010. September 1;51(5):496–505. - PubMed
    1. Karras A, Lafaurie M, Furco A, Bourgarit A, Droz D, Sereni D, et al. Tenofovir-related nephrotoxicity in human immunodeficiency virus-infected patients: three cases of renal failure, Fanconi syndrome, and nephrogenic diabetes insipidus. Clin Infect Dis. 2003. April 15;36(8):1070–3. - PubMed

Publication types