OBJECTIVES: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. DESIGN: A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. METHODS: CKD was defined as either confirmed (two measurements >or=3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m or below for persons with baseline eGFR of above 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. RESULTS: Two hundred and twenty-five (3.3%) persons progressed to CKD during 21 482 person-years follow-up, an incidence of 1.05 per 100 person-years follow-up [95% confidence interval (CI) 0.91-1.18]; median follow-up was 3.7 years (interquartile range 2.8-5.7). After adjustment for traditional factors associated with CKD and other confounding variables, increasing cumulative exposure to tenofovir [incidence rate ratio (IRR) per year 1.16, 95% CI 1.06-1.25, P < 0.0001), indinavir (IRR 1.12, 95% CI 1.06-1.18, P < 0.0001), atazanavir (IRR 1.21, 95% CI 1.09-1.34, P = 0.0003) and lopinavir/r (IRR 1.08, 95% CI 1.01-1.16, P = 0.030) were associated with a significantly increased rate of CKD. Consistent results were observed in wide-ranging sensitivity analyses, although of marginal statistical significance for lopinavir/r. No other antiretroviral drugs were associated with increased incidence of CKD. CONCLUSION: In this nonrandomized large cohort, increasing exposure to tenofovir was associated with a higher incidence of CKD, as was true for indinavir and atazanavir, whereas the results for lopinavir/r were less clear.
OBJECTIVES:Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. DESIGN: A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. METHODS: CKD was defined as either confirmed (two measurements >or=3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m or below for persons with baseline eGFR of above 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. RESULTS: Two hundred and twenty-five (3.3%) persons progressed to CKD during 21 482 person-years follow-up, an incidence of 1.05 per 100 person-years follow-up [95% confidence interval (CI) 0.91-1.18]; median follow-up was 3.7 years (interquartile range 2.8-5.7). After adjustment for traditional factors associated with CKD and other confounding variables, increasing cumulative exposure to tenofovir [incidence rate ratio (IRR) per year 1.16, 95% CI 1.06-1.25, P < 0.0001), indinavir (IRR 1.12, 95% CI 1.06-1.18, P < 0.0001), atazanavir (IRR 1.21, 95% CI 1.09-1.34, P = 0.0003) and lopinavir/r (IRR 1.08, 95% CI 1.01-1.16, P = 0.030) were associated with a significantly increased rate of CKD. Consistent results were observed in wide-ranging sensitivity analyses, although of marginal statistical significance for lopinavir/r. No other antiretroviral drugs were associated with increased incidence of CKD. CONCLUSION: In this nonrandomized large cohort, increasing exposure to tenofovir was associated with a higher incidence of CKD, as was true for indinavir and atazanavir, whereas the results for lopinavir/r were less clear.
Authors: Raj K Medapalli; Chirag R Parikh; Kirsha Gordon; Sheldon T Brown; Adeel A Butt; Cynthia L Gibert; David Rimland; Maria C Rodriguez-Barradas; Chung-Chou H Chang; Amy C Justice; John Cijiang He; Christina M Wyatt Journal: J Acquir Immune Defic Syndr Date: 2012-08-01 Impact factor: 3.731
Authors: Rebecca Scherzer; Michelle Estrella; Yongmei Li; Andy I Choi; Steven G Deeks; Carl Grunfeld; Michael G Shlipak Journal: AIDS Date: 2012-04-24 Impact factor: 4.177
Authors: Lene Ryom; Amanda Mocroft; Ole Kirk; Signe W Worm; David A Kamara; Peter Reiss; Michael Ross; Christoph A Fux; Philippe Morlat; Olivier Moranne; Colette Smith; Jens D Lundgren Journal: J Infect Dis Date: 2013-02-04 Impact factor: 5.226
Authors: A Calcagno; D Gonzalez de Requena; M Simiele; A D'Avolio; M C Tettoni; B Salassa; G Orofino; C Bramato; V Libanore; I Motta; P Bigliano; E Orsucci; G Di Perri; S Bonora Journal: Antimicrob Agents Chemother Date: 2013-02-04 Impact factor: 5.191
Authors: Lloyd Mulenga; Patrick Musonda; Albert Mwango; Michael J Vinikoor; Mary-Ann Davies; Aggrey Mweemba; Alexandra Calmy; Jeffrey S Stringer; Olivia Keiser; Benjamin H Chi; Gilles Wandeler Journal: Clin Infect Dis Date: 2014-02-27 Impact factor: 9.079