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Glomerular filtration rates in HIV-infected patients treated with and without tenofovir: a prospective, observational study.

Authors :
Guaraldi G
Roverato A
Giovanardi C
Ravera F
Squillace N
Orlando G
Cappelli G
Esposito R
Palella F
Source :
The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2009 Feb; Vol. 63 (2), pp. 374-9. Date of Electronic Publication: 2008 Dec 17.
Publication Year :
2009

Abstract

Objectives: The aim of our study was to assess the impact of plasma HIV-1 RNA level [viral load (VL)] variation and tenofovir exposure on kidney functions by analysing changes in calculated glomerular filtration rates (GFRs) over a 48 week period in patients with mild renal impairment.<br />Patients and Methods: A prospective observational study that included data from all consecutive HIV-infected patients who attended a metabolic clinic was conducted. Included were adult, antiretroviral (ARV)-experienced, tenofovir-naive patients, whose kidney functions were evaluated by calculated GFR using the simplified Modification of Diet in Renal Disease study equation (MDRD). Tenofovir-exposed patients were patients who initiated tenofovir therapy at baseline and tenofovir-unexposed patients were patients whose ARV therapy did not include tenofovir. Participants were stratified into three sub-groups according to the plasma HIV-1 RNA (VL) changes observed: sub-groups 1, 2 and 3 were patients with stable VL < or =50 copies/mL, >0.5 log(10) VL increases and >0.5 VL log(10) decreases, respectively.<br />Results: Ninety-nine patients were enrolled and included in the analysis. Within the tenofovir-unexposed group, GFRs remained stable (ANOVA, P = 0.94) over the follow-up period. Within the tenofovir-exposed group, mean GFR changes varied significantly by sub-group (ANOVA, P < 0.01). In particular, GFR changes in sub-group 3 (+8.4 +/- 12.4 mL/min) were different from those seen in sub-group 1 (-1.0 +/- 8.8 mL/min) (P < 0.05) and sub-group 2 (-4.6 +/- 8.8 mL/min) (P < 0.01).<br />Conclusions: Observed improvements in GFR that occurred as a consequence of highly active ARV therapy-induced viral suppression may have more than offset any potential negative effects of tenofovir on renal function.

Details

Language :
English
ISSN :
1460-2091
Volume :
63
Issue :
2
Database :
MEDLINE
Journal :
The Journal of antimicrobial chemotherapy
Publication Type :
Academic Journal
Accession number :
19095683
Full Text :
https://doi.org/10.1093/jac/dkn499