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
Observational Study
. 2020 Oct;21(9):607-612.
doi: 10.1111/hiv.12899. Epub 2020 Jul 22.

Estimated glomerular filtration rate slopes on tenofovir alafenamide

F Ibrahim  1 , L Campbell  2 , A C Bailey  3 , S Stockwell  4 , L Waters  5 , C Orkin  6 , M Johnson  7 , M Gompels  8 , A De Burgh-Thomas  9 , R Jones  10 , G Schembri  11 , P W Mallon  12 , F A Post  1   2
Affiliations
Free article
Observational Study

Estimated glomerular filtration rate slopes on tenofovir alafenamide

F Ibrahim et al. HIV Med. 2020 Oct.
Free article

Abstract

Objectives: The aim of the study was to analyse and compare estimated glomerular filtration rate (eGFR) slopes during exposure to tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) in individuals who initiated TAF, regardless of prior regimen, before October 2016.

Methods: An observational cohort study was conducted at 11 clinics in the UK and Ireland. Mixed effects models with random intercept and time terms fitted were used to generate and compare eGFR slopes while participants were exposed to TDF and TAF, with adjustment for age, eGFR at TDF/TAF initiation, gender, ethnicity, and time-updated CD4 cell count and HIV RNA measurements.

Results: Data were available for 357 subjects (median age 50 years; 80% male; 82% white/other ethnicity; 51% men who have sex with men; median nadir CD4 count 216 cells/µL). The median duration of exposure to TAF was 2.0 (interquartile range 1.6, 2.3) years. At TAF initiation, the median CD4 count was 557 cells/µL, the median eGFR was 80 mL/min/1.73 m2, and 86% had suppressed HIV infection. The mean adjusted eGFR slope during TDF and TAF exposure was -2.08 [95% confidence interval (CI) -2.24, -1.92] and 1.18 (95% CI 0.20, 1.52) mL/min/1.73 m2/year, respectively (P < 0.001). Individuals who experienced rapid eGFR decline (> 3 or 5 mL/min/1.73 m2/year) while receiving TDF experienced significant eGFR recovery while on TAF (P < 0.001).

Conclusions: Significant improvement in eGFR slope was observed in patients who switched from TDF- to TAF-containing antiretroviral regimens. These data provide further support for the renal safety of TAF, and for switching those who experience progressive worsening of renal function from TDF to TAF.

Keywords: estimated glomerular filtration rate slope; kidney; tenofovir alafenamide; tenofovir disoproxil fumarate; tubulopathy.

PubMed Disclaimer

References

    1. Scherzer R, Estrella M, Li Y et al. Association of tenofovir exposure with kidney disease risk in HIV infection. AIDS 2012; 26: 867-875.
    1. Mocroft A, Lundgren JD, Ross M et al. Cumulative and current exposure to potentially nephrotoxic antiretrovirals and development of chronic kidney disease in HIV-positive individuals with a normal baseline estimated glomerular filtration rate: a prospective international cohort study. Lancet HIV 2016; 3: e23-e32.
    1. Fux CA, Simcock M, Wolbers M et al. Tenofovir use is associated with a reduction in calculated glomerular filtration rates in the Swiss HIV Cohort Study. Antivir Ther 2007; 12: 1165-1173.
    1. Labarga P, Barreiro P, Martin-Carbonero L et al. Kidney tubular abnormalities in the absence of impaired glomerular function in HIV patients treated with tenofovir. AIDS 2009; 23: 689-696.
    1. Hamzah L, Booth JW, Jose S et al. Renal tubular disease in the era of combination antiretroviral therapy. AIDS. 2015; 29: 1831-1836.

MeSH terms