Sylvie Bregigeon1, Caroline Solas2, Olivia Faucher1, Véronique Obry-Roguet1, Catherine Tamalet3, Isabelle Poizot-Martin1,4. 1. Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France. 2. Aix-Marseille University, APHM La Timone, Pharmacocinétique et Toxicologie, INSERM S_911 CRO2-SMARTc, Marseille, France. 3. IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, APHM Timone, Marseille, France. 4. INSERM U912 (SESSTIM), Marseille, France.
Abstract
BACKGROUND: Tenofovir disoproxil fumarate (TDF)-based regimen is a treatment option for HIV-infected patients. TDF dose adjustment is recommended in patients with impaired renal function. We assessed the impact of TDF dose adjustment on renal function and tenofovir trough concentration. METHODS: Fourteen HIV patients for whom TDF dose was adjusted (1 tablet/48 h) because of estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, and/or due to a tenofovir trough concentration >90 ng/ml between 2006 and 2013 were selected. The eGFR was measured at baseline and 3, 6 and 12 months after TDF dose adjustment. RESULTS: A 50% TDF dose reduction resulted in a significant increase of the eGFR 3 months after dose adjustment (61.1 versus 72.8 ml/min/1.73 m2; P=0.003). Concomitantly, tenofovir trough concentration decreased from 175 to 66 ng/ml (P=0.009). Antiviral efficacy was maintained in all patients. CONCLUSIONS: TDF dose adjustment combined with therapeutic drug monitoring may be useful especially in patients at risk of kidney dysfunction.
BACKGROUND:Tenofovir disoproxil fumarate (TDF)-based regimen is a treatment option for HIV-infectedpatients. TDF dose adjustment is recommended in patients with impaired renal function. We assessed the impact of TDF dose adjustment on renal function and tenofovir trough concentration. METHODS: Fourteen HIVpatients for whom TDF dose was adjusted (1 tablet/48 h) because of estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, and/or due to a tenofovir trough concentration >90 ng/ml between 2006 and 2013 were selected. The eGFR was measured at baseline and 3, 6 and 12 months after TDF dose adjustment. RESULTS: A 50% TDF dose reduction resulted in a significant increase of the eGFR 3 months after dose adjustment (61.1 versus 72.8 ml/min/1.73 m2; P=0.003). Concomitantly, tenofovir trough concentration decreased from 175 to 66 ng/ml (P=0.009). Antiviral efficacy was maintained in all patients. CONCLUSIONS:TDF dose adjustment combined with therapeutic drug monitoring may be useful especially in patients at risk of kidney dysfunction.
Authors: Rosbel M Brito; Duc T Nguyen; Justine R Johnson; Eric J Lai; Rochelle E Castro; Angelina M Albert; Ann S Barnes; Edward A Graviss; Wadi N Suki Journal: PLoS One Date: 2019-04-17 Impact factor: 3.240