Long term renal function in Asian HIV-1 infected adults receiving tenofovir disoproxil fumarate without protease inhibitors.


Journal

The Journal of infection
ISSN: 1532-2742
Titre abrégé: J Infect
Pays: England
ID NLM: 7908424

Informations de publication

Date de publication:
11 2019
Historique:
received: 27 02 2019
revised: 19 07 2019
accepted: 06 08 2019
pubmed: 12 8 2019
medline: 17 7 2020
entrez: 12 8 2019
Statut: ppublish

Résumé

The risk of kidney dysfunction on the WHO recommended first line regimens containing tenofovir disoproxil fumarate (TDF) without protease inhibitors (PI) remains unclear in Asian patients, especially those with low body weight. Using data collected in a multicenter clinical trial in Thailand and proportional hazard regression models, we compared the risk of a >25% estimated glomerular filtration rate (eGFR) reduction in HIV naïve patients initiating TDF or zidovudine (AZT) containing non-PI regimen. Of 640 patients included in the analysis, 461 (72%) received a TDF-containing regimen for a median 6.7 years and 179 (28%) an AZT-containing regimen for 6.5 years. The risk of a >25% eGFR reduction was not associated with treatment (HR 1.11, 95% CI 0.84-1.47, P = 0.46). In multivariate analysis, the risk of >25% eGFR reduction form baseline was associated with body weight at baseline (HR 2.12, 95% CI 1.48-3.02 for <48 kg patients and HR 1.64, 95% CI 1.20-2.25 for 48-59.9 kg patients, compared to those with >60 kg, P < 0.001) and hypertension (HR 4.03, 95% CI 2.0-8.0, P < 0.001). The effect of baseline weight on >25% eGFR reduction did not significantly vary with treatment (P = 0.27). The risk of eGFR reduction was not higher on TDF- versus AZT-based non-PI regimens. Although the risk of eGFR reduction was greater for patients of lower body weight, this risk was not significantly increased by TDF.

Identifiants

pubmed: 31401085
pii: S0163-4453(19)30245-2
doi: 10.1016/j.jinf.2019.08.006
pmc: PMC6825894
mid: NIHMS1538874
pii:
doi:

Substances chimiques

Anti-HIV Agents 0
Zidovudine 4B9XT59T7S
Tenofovir 99YXE507IL

Types de publication

Comparative Study Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

454-461

Subventions

Organisme : NICHD NIH HHS
ID : R01 HD042964
Pays : United States

Informations de copyright

Copyright © 2019. Published by Elsevier Ltd.

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Auteurs

Geoffroy Liegeon (G)

Institut de Recherche pour le Développement (IRD) Unit 174-PHPT, Kaew Nawarat Rd, Tambon Wat Ket, Amphoe Mueang Chiang Mai, Chiang Mai, Thailand. Electronic address: geoffroy.liegeon@phpt.org.

Linda Harrison (L)

Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Anouar Nechba (A)

Institut de Recherche pour le Développement (IRD) Unit 174-PHPT, Kaew Nawarat Rd, Tambon Wat Ket, Amphoe Mueang Chiang Mai, Chiang Mai, Thailand. Electronic address: anouar.nechba@phpt.org.

Guttiga Halue (G)

Phayao Provincial Hospital, Phayao, Thailand.

Sukit Banchongkit (S)

Rayong Hospital, Rayong, Thailand.

Ampaipith Nilmanat (A)

Hat Yai Hospital, Songkla, Thailland. Electronic address: app-nil@windowslive.com.

Naruepon Yutthakasemsunt (N)

Nong Khai Hospital, Nong Khai, Thailand.

Panita Pathipvanich (P)

Lampang Hospital, Lampang, Thailand.

Suchart Thongpaen (S)

Mahasarakam Hospital, Mahasarakam, Thailand.

Rittha Lertkoonalak (R)

Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.

Thomas Althaus (T)

Institut de Recherche pour le Développement (IRD) Unit 174-PHPT, Kaew Nawarat Rd, Tambon Wat Ket, Amphoe Mueang Chiang Mai, Chiang Mai, Thailand. Electronic address: thomas.althaus@hotmail.fr.

Marc Lallemant (M)

Institut de Recherche pour le Développement (IRD) Unit 174-PHPT, Kaew Nawarat Rd, Tambon Wat Ket, Amphoe Mueang Chiang Mai, Chiang Mai, Thailand; Harvard T.H. Chan School of Public Health, Boston, MA, USA; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. Electronic address: marc.lallemant@phpt.org.

Jean-Yves Mary (JY)

INSERM SBIM, Hôpital Saint Louis, 1 avenue Claude Vellefaux, 75011 Paris, France. Electronic address: jean-yves.mary@inserm.fr.

Gonzague Jourdain (G)

Institut de Recherche pour le Développement (IRD) Unit 174-PHPT, Kaew Nawarat Rd, Tambon Wat Ket, Amphoe Mueang Chiang Mai, Chiang Mai, Thailand; Harvard T.H. Chan School of Public Health, Boston, MA, USA; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. Electronic address: gonzague.jourdain@phpt.org.

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