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Review
. 2020 Mar 10:9:2019-11-1.
doi: 10.7573/dic.2019-11-1. eCollection 2020.

HIV, drugs and the kidney

Nicola Wearne  1 , Bianca Davidson  1 , Marc Blockman  2 , Annoesjka Swart  2 , Erika Sw Jones  1
Affiliations
Review

HIV, drugs and the kidney

Nicola Wearne et al. Drugs Context. .

Abstract

Human immunodeficiency virus (HIV) affects over 36 million people worldwide. Antiretroviral therapy (ART) is expanding and improving HIV viral suppression, resulting in increasing exposure to drugs and drug interactions. Polypharmacy is a common complication as people are living longer on ART, increasing the risk of drug toxicities. Polypharmacy is related not only to ART exposure and medication for opportunistic infections, but also to treatment of chronic lifestyle diseases. Acute kidney injury (AKI) is frequent in HIV and is commonly the result of sepsis, dehydration and drug toxicities. Furthermore, HIV itself increases the risk of chronic kidney disease (CKD). Drug treatment is often complicated in people living with HIV because of a greater incidence of AKI and/or CKD compared to the HIV-negative population. Impaired renal function affects drug interactions, drug toxicities and importantly drug dosing, requiring dose adjustment. This review discusses ART and its nephrotoxic effects, including drug-drug interactions. It aims to guide the clinician on dose adjustment in the setting of renal impairment and dialysis, for the commonly used drugs in patients with HIV.

Keywords: HIV; drugs interactions; kidney injury; nephrotoxicity; renal dose adjustment.

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Conflict of interest statement

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at https://www.drugsincontext.com/wp-content/uploads/2020/02/dic.2019-11-1-COI.pdf

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