Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine

Dita C Bolluyt¹, Mark A M van den Elshout¹, Eline S Wijstma¹, Anders Boyd^{1

2

3

4}, Elske Hoornenborg¹, Henry J C De Vries^{1

3

5}, Maria Prins^{1

3

4}, Liffert Vogt⁶, Maarten F Schim van der Loeff^{1

3

4}; Amsterdam PrEP Project Team in the HIV Transmission Elimination AMsterdam Initiative (H-TEAM)

Collaborators, Affiliations

Collaborators

Amsterdam PrEP Project Team in the HIV Transmission Elimination AMsterdam Initiative (H-TEAM):
T van Benthem, D Bons, G J de Bree, P Brokx, U Davidovich, S Hendriks, S E Geerlings, M Heidenrijk, E Hoornenborg, J Heijne, P Reiss, A van Sighem, M van der Valk, J de Wit, P Zantkuijl, N Schat, L Dol, M van Agtmael, J Ananworanich, D Van de Beek, G E L van den Berk, D Bezemer, A van Bijnen, J P Bil, W L Blok, S Bogers, M Bomers, A Boyd, W Brokking, D Burger, K Brinkman, N Brinkman, M de Bruin, S Bruisten, L Coyer, R van Crevel, M Dijkstra, Y T van Duijnhoven, A van Eeden, L Elsenburg, M A M van den Elshout, E Ersan, P E V Felipa, T B H Geijtenbeek, J van Gool, A Goorhuis, M Groot, C A Hankins, A Heijnen, M M J Hillebregt, M Hommenga, J W Hovius, Y Janssen, K de Jong, V Jongen, N A Kootstra, R A Koup, F P Kroon, T J W van de Laar, F Lauw, M M van Leeuwen, K Lettinga, I Linde, D S E Loomans, I M van der Lubben, J T van der Meer, T Mouhebati, B J Mulder, J Mulder, F J Nellen, A Nijsters, H Nobel, E L M Op de Coul, E Peters, I S Peters, T van der Poll, O Ratmann, C Rokx, M F Schim van der Loeff, W E M Schoute, J Schouten, J Veenstra, A Verbon, F Verdult, J de Vocht, H J de Vries, S Vrouenraets, M van Vugt, W J Wiersinga, F W Wit, L R Woittiez, S Zaheri, P Zantkuijl, Żakowicz, M C van Zelm, H M L Zimmermann

Affiliations

¹ Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
² Stichting HIV Monitoring, Amsterdam, The Netherlands.
³ Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁴ Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
⁶ Department of Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

PMID: 40630314
PMCID: PMC12231006
DOI: 10.1016/j.ekir.2025.03.033

Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine

Dita C Bolluyt et al. Kidney Int Rep. 2025.

. 2025 Mar 25;10(6):2003-2014.

doi: 10.1016/j.ekir.2025.03.033. eCollection 2025 Jun.

Authors

Collaborators

Amsterdam PrEP Project Team in the HIV Transmission Elimination AMsterdam Initiative (H-TEAM):
T van Benthem, D Bons, G J de Bree, P Brokx, U Davidovich, S Hendriks, S E Geerlings, M Heidenrijk, E Hoornenborg, J Heijne, P Reiss, A van Sighem, M van der Valk, J de Wit, P Zantkuijl, N Schat, L Dol, M van Agtmael, J Ananworanich, D Van de Beek, G E L van den Berk, D Bezemer, A van Bijnen, J P Bil, W L Blok, S Bogers, M Bomers, A Boyd, W Brokking, D Burger, K Brinkman, N Brinkman, M de Bruin, S Bruisten, L Coyer, R van Crevel, M Dijkstra, Y T van Duijnhoven, A van Eeden, L Elsenburg, M A M van den Elshout, E Ersan, P E V Felipa, T B H Geijtenbeek, J van Gool, A Goorhuis, M Groot, C A Hankins, A Heijnen, M M J Hillebregt, M Hommenga, J W Hovius, Y Janssen, K de Jong, V Jongen, N A Kootstra, R A Koup, F P Kroon, T J W van de Laar, F Lauw, M M van Leeuwen, K Lettinga, I Linde, D S E Loomans, I M van der Lubben, J T van der Meer, T Mouhebati, B J Mulder, J Mulder, F J Nellen, A Nijsters, H Nobel, E L M Op de Coul, E Peters, I S Peters, T van der Poll, O Ratmann, C Rokx, M F Schim van der Loeff, W E M Schoute, J Schouten, J Veenstra, A Verbon, F Verdult, J de Vocht, H J de Vries, S Vrouenraets, M van Vugt, W J Wiersinga, F W Wit, L R Woittiez, S Zaheri, P Zantkuijl, Żakowicz, M C van Zelm, H M L Zimmermann

Affiliations

¹ Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
² Stichting HIV Monitoring, Amsterdam, The Netherlands.
³ Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁴ Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
⁶ Department of Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

PMID: 40630314
PMCID: PMC12231006
DOI: 10.1016/j.ekir.2025.03.033

Abstract

Introduction: Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is used as oral preexposure prophylaxis (PrEP) to prevent HIV. Because TDF could be nephrotoxic, we assessed the association between PrEP use and kidney function over time.

Methods: We included men who have sex with men (MSM) from the Amsterdam PrEP demonstration Project (AMPrEP; 2015-2020) at the Public Health Service of Amsterdam, who had an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min per 1.73 m2 and ≥ 1 creatinine measurement after baseline. Participants could choose between daily or event-driven PrEP use. Plasma creatinine was measured at PrEP commencement and annually thereafter. Kidney function was calculated as the eGFR using the 2021 Chronic Kidney Disease-Epidemiology Collaboration formula.

Results: Among the 351 participants analyzed (median age: 41 years, interquartile range [IQR] = 33-49), mean eGFR at PrEP commencement was 100 ml/min per 1.73 m2 (SD = 14). During a median follow-up of 54.2 months (IQR = 47.0-57.6), eGFR decreased by 0.30/yr (95% confidence interval [CI] = - 0.59 to - 0.01). We observed lower mean eGFR decline in those using daily PrEP than in those using event-driven PrEP (- 3.05, 95% CI = - 3.95 to - 2.15), and in older participants (- 5.75/10 yrs, 95% CI = - 6.70 to - 4.80). Daily PrEP users had an average decline in eGFR of 0.57 ml/min per 1.73 m2/yr (95% CI = - 1.06 to - 0.08), and there was no statistically significant decline in event-driven PrEP users (P for interaction = 0.30). Twelve participants (3.4%) had an incident eGFR < 60 during follow-up, none of which persisted.

Conclusion: Daily PrEP users had a faster decline over time than event-driven PrEP users, yet eGFR declines were low and within the range of those expected in the general population. Our data support reduced kidney function monitoring in PrEP users at low risk for kidney dysfunction.

Keywords: HIV; eGFR; kidney function; men who have sex with men; preexposure prophylaxis.

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Figures

**Figure 1**
Scatterplot and regression lines of estimated glomerular filtration rate over time by PrEP regimen among AMPrEP participants, Amsterdam, The Netherlands, 2015-2020 (N = 351). AMPrEP, Amsterdam PrEP demonstration project; PrEP, preexposure prophylaxis.

**Figure 2**
Scatterplot and regression lines of estimated glomerular filtration rate over time by age categories among AMPrEP participants, Amsterdam, The Netherlands, 2015–2020 (N = 351). AMPrEP, Amsterdam PrEP demonstration project; PrEP, preexposure prophylaxis.

See this image and copyright information in PMC

References

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1. UNAIDS Global HIV & AIDS Statistics—Fact Sheet 2024. United Nations. https://www.unaids.org/en/resources/fact-sheet
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1. World Health Organization; Geneva: 2024. WHO Implementation Tool for Pre-Exposure Prophylaxis (PrEP) of HIV Infection: Provider Module for Oral and Long-acting PrEP.
1. Hall A.M., Hendry B.M., Nitsch D., Connolly J.O. Tenofovir-associated kidney toxicity in HIV-infected patients: a review of the evidence. Am J Kidney Dis. 2011;57:773–780. doi: 10.1053/j.ajkd.2011.01.022. - DOI - PubMed

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Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine

Collaborators

Affiliations

Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine

Authors

Collaborators

Affiliations

Abstract

Figures

References

LinkOut - more resources

Full Text Sources

Research Materials

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