Incidence and Risk Factors for Tenofovir-Associated Renal Function Decline Among Thai HIV-Infected Patients with Low-Body Weight

Chaisiri, Kessarin; Bowonwatanuwong, Chureeratana; Kasettratat, Narat; Kiertiburanakul, Sasisopin

doi:10.2174/157016210793499259

Cited by 49 publications

(80 citation statements)

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“…Median (IQR) time to renal function decline was 8 (3-13.5), 11 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), and 11 (6-19) months, respectively, when estimated from the total number of the patients. By Kaplan-Meier analysis, median time to renal function decline was 28 (95% CI 25-30) months for eGFR criteria and 31 (95% CI 28-34) months for CCrCl criteria.…”

Section: Resultsmentioning

confidence: 99%

“…Our group and the others also have reported subtle changes in CCrCl or eGFR associated with TDF. 9,11,23 In addition, the recent systematic review and meta-analysis demonstrates that there was a significant renal function decline including acute kidney injury among individuals receiving TDF, compared with control participants. 24 Nevertheless, some groups have reported slight changes in renal function without clinically relevant renal disease.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, reports describing nephrotoxicity attributable to TDF in HIV-infected patients have been increasingly published, such as changes in renal function (either glomerular or tubular function), acute renal failure, Fanconi syndrome, or nephrogenic diabetes insipidus. [9][10][11][12][13] This is because TDF is eliminated by renal clearance, largely by glomerular filtration, with 20% to 30% being actively transported into renal proximal tubule cells. 7 Several biomarkers are available for monitoring of renal function, although no consensus exists on how best to apply these methods for HIV-infected patients.…”

Section: Introductionmentioning

confidence: 99%

“…Some cohort studies described no significant evidence of renal dysfunction with the use of TDF [15][16][17] in contrast to the other study. 9 Most of HIV-infected patients' care in Thailand, where is a resource-limited setting, is covered by the National AIDS Program. Therefore, we aimed to investigate the different methods, using serum creatinine (SCr), calculated CrCl (CCrCl), and eGFR, for the monitoring of renal function among HIV-infected patients receiving TDF in routine HIV clinical care.…”

Section: Introductionmentioning

confidence: 99%

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Monitoring of Renal Function among HIV-Infected Patients Receiving Tenofovir in a Resource-Limited Setting

Kiertiburanakul

Chaisiri

Kasettratat

et al. 2011

Journal of the International Association of Physicians in AIDS

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The use of tenofovir disoproxil fumarate (TDF) is supposed to be increased in a resource-limited setting due to the changing of the guidelines. TDF-associated renal function declines among HIV-infected patients were defined by an increase of serum creatinine (SCr) >1.5 times, a 25% decrease in calculated creatinine clearance (CCrCl), or an estimated glomerular filtration rate (eGFR) from the baseline. Of all, 99% were antiretroviral treatment (ART)-experienced patients. At the 30th month, 19 (5.3%), 53 (14.9%), and 63 (17.7%) patients had renal function decline as defined by the above criteria with an incidence of 4.5, 12.5, and 14.6/100 person-year. A proportion of patients with a renal function decline detected by CCrCl or eGFR criteria was not different (P ¼ .301), whereas, it differed from that detected by SCr criteria (P < .001). In conclusion, we encourage either CCrCl or eGFR calculations in monitoring renal function decline among HIV-infected patients receiving TDF in resource-limited settings.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Monitoring of Renal Function among HIV-Infected Patients Receiving Tenofovir in a Resource-Limited Setting

Kiertiburanakul

Chaisiri

Kasettratat

et al. 2011

Journal of the International Association of Physicians in AIDS

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“…The efficacy and safety of these two fixed-dose regimens in patients with different genetic backgrounds and body statures might not be similar to the results of previous trials, especially considering that the prevalence of HLA-B*5701 is zero in the Japanese population (7). Moreover, the degree of decrement in the renal function with TDF is larger in patients with a low body weight, such as the Japanese, which might limit the use of TDF in patients with a high risk for renal dysfunction (18)(19)(20). Based on the above described background, the present randomized trial was originally designed in 2007 to elucidate whether the viral efficacy of ABC/3TC is not inferior to that of TDF/FTC with ritonavir-(100 mg) boosted atazanavir (300 mg) in treatment-naïve Japanese patients, whose body weight is much lower than Whites or Blacks (21).…”

Section: Introductionmentioning

confidence: 84%

Abacavir/Lamivudine versus Tenofovir/Emtricitabine with Atazanavir/Ritonavir for Treatment-naive Japanese Patients with HIV-1 Infection: A Randomized Multicenter Trial

et al. 2013

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Objective To compare the efficacy and safety of fixed-dose abacavir/lamivudine (ABC/3TC) and tenofovir/ emtricitabine (TDF/FTC) with ritonavir-boosted atazanavir (ATV/r) in treatment-naïve Japanese patients with HIV-1 infection. Methods A 96-week multicenter, randomized, open-label, parallel group pilot study was conducted. The endpoints were times to virologic failure, safety event and regimen modification. Results 109 patients were enrolled and randomly allocated (54 patients received ABC/3TC and 55 patients received TDF/FTC). All randomized subjects were analyzed. The time to virologic failure was not significantly different between the two arms by 96 weeks (HR, 2.09; 95% CI, 0.72-6.13; p=0.178). Both regimens showed favorable viral efficacy, as in the intention-to-treat population, 72.2% (ABC/3TC) and 78.2% (TDF/ FTC) of the patients had an HIV-1 viral load <50 copies/mL at 96 weeks. The time to the first grade 3 or 4 adverse event and the time to the first regimen modification were not significantly different between the two arms (adverse event: HR 0.66; 95% CI, 0.25-1.75, p=0.407) (regimen modification: HR 1.03; 95% CI, 0.33-3.19, p=0.964). Both regimens were also well-tolerated, as only 11.1% (ABC/3TC) and 10.9% (TDF/FTC) of the patients discontinued the allocated regimen by 96 weeks. Clinically suspected abacavir-associated hypersensitivity reactions occurred in only one (1.9%) patient in the ABC/3TC arm. Conclusion Although insufficiently powered to show non-inferiority of viral efficacy of ABC/3TC relative to TDF/FTC, this pilot trial suggested that ABC/3TC with ATV/r is a safe and efficacious initial regimen for HLA-B*5701-negative patients, such as the Japanese population.

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Is the risk of tenofovir‐induced nephrotoxicity similar in treatment‐naïve compared to treatment‐experienced patients?

Low

Khoo

Azmi

et al. 2018

Pharmacy Practice and Res

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Background: Tenofovir disoproxil fumarate (TDF) is the recommended first-line nucleoside reverse transcriptase inhibitor (NRTI) in the management of human immunodeficiency virus (HIV); however, its use is associated with nephrotoxicity. Aim: To assess if the risks of renal impairment were similar in treatment-na€ ıve compared to treatment-experienced patients initiating tenofovir given their different background clinical characteristics. Method: This was a retrospective observational study conducted at the University Malaya Medical Centre, Malaysia and included all HIV-infected adults who received tenofovir for at least 3 months and had an estimated glomerular filtration rate (eGFR) >60 mL/ min at tenofovir initiation. The incidence of renal impairment was defined as a 25% decrease in eGFR from baseline or the development of chronic kidney disease. Clinical and demographic characteristics were extracted from medical records. Risk factors associated with tenofovir-induced renal impairment were determined using multivariate logistic regression. Results: This study included 314 patients and almost half of them (49%) were treatment-na€ ıve at tenofovir initiation. The majority of patients were male (89.5%) with a median (interquartile range) baseline creatinine clearance of 99.1 mL/min (85.0-114.0). Thirty (9.4%) patients developed tenofovir-induced renal impairment and the incidence rate was higher in treatment-experienced versus treatment-na€ ıve patients (7.0 vs 3.3 cases/100 person-years, p = 0.049). Risk factors associated with tenofovir-induced nephrotoxicity in multivariate analysis were older age (p = 0.001), anaemia (p = 0.027), concurrent hypertension (p = 0.014) and higher baseline eGFR (p = 0.007). Conclusion: Treatment experience was not an independent risk factor but was rather confounded by multiple characteristics associated with an increased risk of TDF-induced nephrotoxicity. Monitoring all patients presenting with these risks regardless of treatment experience is crucial.

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Incidence and Risk Factors for Tenofovir-Associated Renal Function Decline Among Thai HIV-Infected Patients with Low-Body Weight

Cited by 49 publications

References 0 publications

Monitoring of Renal Function among HIV-Infected Patients Receiving Tenofovir in a Resource-Limited Setting

Monitoring of Renal Function among HIV-Infected Patients Receiving Tenofovir in a Resource-Limited Setting

Abacavir/Lamivudine versus Tenofovir/Emtricitabine with Atazanavir/Ritonavir for Treatment-naive Japanese Patients with HIV-1 Infection: A Randomized Multicenter Trial

Is the risk of tenofovir‐induced nephrotoxicity similar in treatment‐naïve compared to treatment‐experienced patients?

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