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Abstract
Renal function changes at two years in HIV-infected patients treated with tenofovir-DF
Javanbakht M.1, Khanlou H.1, Chien C.1, Denouden P.1, Voskanian A.1, Kaur P.1, Farthing C.1
Objective: The objective of this study was to compare changes in renal function in individuals receiving tenofovir disoproxil fumarate (TDF) and non-TDF-containing combination antiretroviral regimen over a 2-year period.
Methods: Electronic medical records were used to conduct a retrospective cohort study of patients starting a TDF-containing regimen between 2001 and 2003. These patients were matched on HIV viral load and CD4 cell counts to subjects receiving a non-TDF based regimen. All patients were followed for 2-years. Changes in creatinine clearance (CrCl) were compared between groups at 6, 12, and 24 months. Differences were evaluated using chi-square methods and multivariate analyses were conducted using logistic regression.
Results: A total of 896 patients were identified and included in the study. Baseline characteristics including age, gender, race/ethnicity, diabetes, hypertension, substance abuse, and creatinine levels were similar between the two groups. While CrCl declined in a greater percent of those receiving TDF at 6 and 12 months after initiation of therapy, both clinical and statistically meaningful decline was noted 2-years after initiation of therapy. After 24-months of follow-up, 23.2% of those on a TDF-based regimen experienced a decline of ³ 30 ml/min as compared to 9.7% of those on a non-TDF based regimen (p=0.0041). After adjusting for diabetes, hepatitis C coinfection, and baseline viral load and CD4 counts, patients on a TDF-based regimen were 3.2 times more likely to experience a decline in renal function as compared to those on non-TDF regimen [odds ratio (OR)=3.2; 95% confidence interval (CI) 1.5 – 6.9].
Conclusions: In this clinical cohort, the inclusion of TDF in antiretroviral regimen was associated with a greater decline in renal function at 24 months than for combination regimens which did not include TDF. Closer monitoring may thus be warranted in patients treated with TDF-containing regimens, even where baseline creatinine clearance is normal.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
MOPEB064
Suggested Citation
"JavanbakhtM., et al.
Renal function changes at two years in HIV-infected patients treated with tenofovir-DF.
Poster exhibition:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
MOPEB064"
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