BACKGROUND: Impaired renal function is of major concern in human immunodeficiency virus (HIV)-infected patients. METHODS: We used a mixed effects linear regression model to determine estimated glomerular filtration rates (eGFRs) in a population-based cohort of incident Danish HIV patients and stratified on baseline eGFR (eGFR(B)) < 90 and ≥ 90 ml/min per 1.73 m(2). Incidence rate ratios (IRRs) for chronic kidney disease (CKD) - 2 consecutive eGFR values < 60 ml/min per 1.73 m(2) measured > 3 months apart - were estimated (time-updated Cox-regression model). RESULTS: The effect of time with HIV on eGFR was small in both strata (- 0.09 (95% confidence interval (CI) - 0.27, 0.09) and - 0.46 (95% CI - 0.64, - 0.27) ml/min per 1.73 m(2) per y). Treatment with tenofovir and indinavir was associated with lower eGFR in both strata: tenofovir - 2.00 (95% CI - 3.45, - 0.56) and - 1.94 (95% CI - 3.43, - 0.44) ml/min per 1.73 m(2) and indinavir - 2.14 (95% CI - 3.63, - 0.64) and - 3.29 (95% CI - 5.25, - 1.32) ml/min per 1.73 m(2). Nevirapine, atazanavir, and the combination of tenofovir and atazanavir were associated with lower eGFR in patients with eGFR(B) < 90 ml/min per 1.73 m(2). Highly active antiretroviral therapy (HAART) and exposure to tenofovir and atazanavir in combination were associated with CKD in patients with eGFR(B) < 90 ml/min per 1.73 m(2) (adjusted IRRs 6.08 (95% CI 2.76-13.41) and 26.75 (95% CI 9.54-75.05)). CONCLUSION: Tenofovir and indinavir reduce eGFR, while time with HIV only has a modest effect on this parameter. Low eGFR(B) is associated with an increased risk of CKD, especially when receiving HAART regimens containing the combination tenofovir/atazanavir.
BACKGROUND: Impaired renal function is of major concern in human immunodeficiency virus (HIV)-infectedpatients. METHODS: We used a mixed effects linear regression model to determine estimated glomerular filtration rates (eGFRs) in a population-based cohort of incident Danish HIVpatients and stratified on baseline eGFR (eGFR(B)) < 90 and ≥ 90 ml/min per 1.73 m(2). Incidence rate ratios (IRRs) for chronic kidney disease (CKD) - 2 consecutive eGFR values < 60 ml/min per 1.73 m(2) measured > 3 months apart - were estimated (time-updated Cox-regression model). RESULTS: The effect of time with HIV on eGFR was small in both strata (- 0.09 (95% confidence interval (CI) - 0.27, 0.09) and - 0.46 (95% CI - 0.64, - 0.27) ml/min per 1.73 m(2) per y). Treatment with tenofovir and indinavir was associated with lower eGFR in both strata: tenofovir - 2.00 (95% CI - 3.45, - 0.56) and - 1.94 (95% CI - 3.43, - 0.44) ml/min per 1.73 m(2) and indinavir - 2.14 (95% CI - 3.63, - 0.64) and - 3.29 (95% CI - 5.25, - 1.32) ml/min per 1.73 m(2). Nevirapine, atazanavir, and the combination of tenofovir and atazanavir were associated with lower eGFR in patients with eGFR(B) < 90 ml/min per 1.73 m(2). Highly active antiretroviral therapy (HAART) and exposure to tenofovir and atazanavir in combination were associated with CKD in patients with eGFR(B) < 90 ml/min per 1.73 m(2) (adjusted IRRs 6.08 (95% CI 2.76-13.41) and 26.75 (95% CI 9.54-75.05)). CONCLUSION:Tenofovir and indinavir reduce eGFR, while time with HIV only has a modest effect on this parameter. Low eGFR(B) is associated with an increased risk of CKD, especially when receiving HAART regimens containing the combination tenofovir/atazanavir.
Authors: Kedar Joshi; David Boettiger; Stephen Kerr; Takeshi Nishijima; Kinh Van Nguyen; Penh Sun Ly; Man Po Lee; Nagalingeswaran Kumarasamy; Wingwai Wong; Pacharee Kantipong; Do Duy Cuong; Adeeba Kamarulzaman; Jun Yong Choi; Fujie Zhang; Romanee Chaiwarith; Oon Tek Ng; Sasisopin Kiertiburanakul; Benedict Lim Heng Sim; Tuti Parwati Merati; Evy Yunihastuti; Rossana Ditangco; Jeremy Ross; Sanjay Pujari Journal: Pharmacoepidemiol Drug Saf Date: 2018-09-24 Impact factor: 2.890
Authors: Hadas Zachor; Rhoderick Machekano; Michelle M Estrella; Peter J Veldkamp; Michele D Zeier; Olalekan A Uthman; Jantjie J Taljaard; Mohammed R Moosa; Jean B Nachega Journal: AIDS Date: 2016-05-15 Impact factor: 4.177