S Badiou1, A Cournil2, S Toubal3, A S Bargnoux3, A M Dupuy3, C Fernandez4, H Peyriere2, J Reynes5, J P Cristol6. 1. Department of Biochemistry, Montpellier University Hospital, Montpellier, France; UMR 204 NUTRIPASS, Universités Montpellier I/II, Montpellier, France. 2. UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France. 3. Department of Biochemistry, Montpellier University Hospital, Montpellier, France. 4. Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France. 5. UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France; Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France. 6. Department of Biochemistry, Montpellier University Hospital, Montpellier, France; UMR 204 NUTRIPASS, Universités Montpellier I/II, Montpellier, France. Electronic address: jp-crsitol@chu-montpellier.fr.
Abstract
BACKGROUND: The use of reference change value (RCV) instead of reference interval emerged as an alternative approach for longitudinal interpretation of biological marker. Follow-up of creatinine variation in HIV-positive adults remains a challenge in order to prevent renal complications. OBJECTIVES: To determine the long term RCV of creatinine in HIV-positive adults receiving anti-retroviral therapy (ART) according to the use of tenofovir or ritonavir. DESIGN AND METHODS: Longitudinal study of 24 months that include 124 HIV-positive patients followed in HIV outpatient unit. Plasma creatinine was measured at 0, 6, 12 and 24 months in order to calculate the RCV. RESULTS: In the whole group, a 24-month RCV of creatinine was 22.5%. Whatever the ART, the index of individuality was <0.6. Significantly higher RCV of creatinine was observed in patients receiving the association tenofovir and ritonavir (28%) compared to the patients receiving i) tenofovir without ritonavir (21.9%), ii) no tenofovir but ritonavir (22.2%), and iii) no tenofovir and no ritonavir (19.7%). CONCLUSIONS: The low value of index of individuality pinpointed that RCV should be used to identify critical change in serial creatinine results in HIV-positive adults. RCV of creatinine under ART was around 20% but reached 28% in case of association of tenofovir and ritonavir.
BACKGROUND: The use of reference change value (RCV) instead of reference interval emerged as an alternative approach for longitudinal interpretation of biological marker. Follow-up of creatinine variation in HIV-positive adults remains a challenge in order to prevent renal complications. OBJECTIVES: To determine the long term RCV of creatinine in HIV-positive adults receiving anti-retroviral therapy (ART) according to the use of tenofovir or ritonavir. DESIGN AND METHODS: Longitudinal study of 24 months that include 124 HIV-positive patients followed in HIV outpatient unit. Plasma creatinine was measured at 0, 6, 12 and 24 months in order to calculate the RCV. RESULTS: In the whole group, a 24-month RCV of creatinine was 22.5%. Whatever the ART, the index of individuality was <0.6. Significantly higher RCV of creatinine was observed in patients receiving the association tenofovir and ritonavir (28%) compared to the patients receiving i) tenofovir without ritonavir (21.9%), ii) no tenofovir but ritonavir (22.2%), and iii) no tenofovir and no ritonavir (19.7%). CONCLUSIONS: The low value of index of individuality pinpointed that RCV should be used to identify critical change in serial creatinine results in HIV-positive adults. RCV of creatinine under ART was around 20% but reached 28% in case of association of tenofovir and ritonavir.