Determinants of Risk Factors for Renal Impairment among HIV-Infected Patients Treated with Tenofovir Disoproxil Fumarate-Based Antiretroviral Regimen in Southern Vietnam

Abstract

Background. The situation of renal impairment among HIV-infected patients treated with TDF-based antiretroviral (ARV) regimen greater than 3 years is little known when TDF use has been promptly increasing in Vietnam. Methods. We analyse demographic and clinical data from a cross-sectional survey of 400 HIV-infected patients aged ≥18 years, who were treatment-naive or switched TDF regimen within over 3 years between November 2018 and March 2019. Serological tests for serum creatinine, ALT, and AST were performed. Renal impairment was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Multivariate regression analyses were used to explore the risk factors associated with renal impairment. Results. At the baseline, 7.8% of respondents had estimated glomerular filtration rate (eGFR) of 30–59 mL/min/1.73 m2 and 0.8% had eGFR of 15–29 mL/min/1.73 m2, out of 34 (8.5%) of participants who had renal impairment. Multivariate analysis showed that participants who had preexposure to isoniazid (adjusted PR [aPR] = 0.35 Cl: 0.14–0.91) compared with nonexposure to isoniazid who had a BMI from 18.5 up to 25 kg/m2 (aPR = 0.31 Cl: 0.15–0.62) compared with BMI below 18.5 kg/m2 were less likely to suffer from renal impairment. Patients aged greater than 60 years (aPR = 26.75, 95% Cl: 3.38–211.62) compared with those aged 20–29 years were more likely to have increased risk of renal impairment. Conclusion. Our findings underscore the need for longitudinal studies to assess the influence of TDF on maintaining the low prevalence of renal impairment among HIV-infected patients in Vietnam.

Chronic Kidney Disease and Associated Factors Among HIV Infected Patients Taking Tenofovir Disoproxil Fumarate Based Regimen in Ethiopia: A Hospital-Based Cross-Sectional Study

“…The CKD prevalence (4.53%) of the current study is in line with the findings of a study in Tikur Anbessa Specialized Hospital (TASH), 4.8%. 10 However, the finding was lower than the results of studies done in Asia, 9.86%, 8 Vietnam, 8.5%, 12 US Veterans, 14.3%, 11 and University of Gondar Teaching Hospital. 13 On the other hand, the result of the current study was higher than the finding of a study in Cape Town, South Africa, 2%.…”

“…Literatures revealed that older age, 7 , 8 , 12 , 13 female sex, 7 low BMI, 12 , 13 and low CD4 count 13 were significantly associated with CKD. In contrast, the present study showed no significant association of female sex, low BMI, and low CD4 count with CKD.…”

“…Contrary to the previous studies, participants with older age (>50 years old) was less likely to develop CKD in the present study (AOR: 0.22, 95% CI=0.05–0.88, P=0.033). 7 , 8 , 12 , 13 The reason for this discrepancy might be the inclusion of more participants with age of less than or equal to 50 years old in the study.…”

“… 14 Several factors have been identified to be associated with CKD in the TDF-based regimen such as being female, older age, CD4 count less than 200 cells/mm 3 , body mass index (BMI) less than 18.5 kg/m 2 , and longer duration of exposure to the TDF-based regimen. 7 , 12 , 13 In Ethiopia, a TDF-based regimen is the preferred regimen for the treatment of adult HIV-infected patients. However, there are scarce studies on the safety of TDF-based regimens regarding renal function and there is no routine monitoring of renal function in TDF-based regimens.…”

Prevalence of nephropathy and proximal tubule disorder in human immunodeficiency virus patients under tenofovir therapy

“…Hoang et al reported that 8.5% out of 400 cases under tenofovir therapy had renal dysfunction that was related to older age, lower BMI and no exposure to isoniazid therapy (16). Anthropometric and demographic variables and tuberculosis treatment in our study were not related to renal function.…”