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Title: Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia
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
Hospital Sungai Buloh
Beijing Ditan Hospital
VHS Medical Centre India
Bach Mai Hospital
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Kirby Institute
National Center for Global Health and Medicine
The HIV Netherlands Australia Thailand Research Collaboration
Yonsei University College of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Queen Elizabeth Hospital Hong Kong
University of Malaya Medical Centre
Veterans General Hospital-Taipei
Tan Tock Seng Hospital
National Hospital for Tropical Diseases
National Center for HIV/AIDS
amfAR - The Foundation for AIDS Research
Institute of Infectious Diseases
Chiangrai Prachanukroh Hospital
Research Institute for Health Sciences
Keywords: Medicine
Issue Date: 1-Nov-2018
Citation: Pharmacoepidemiology and Drug Safety. Vol.27, No.11 (2018), 1209-1216
Abstract: © 2018 John Wiley & Sons, Ltd. Purpose: Renal disease is common among people living with human immunodeficiency virus (HIV). However, there is limited information on the incidence and risk factors associated with renal dysfunction among this population in Asia. Methods: We used data from the TREAT Asia HIV Observational Database. Patients were included if they started antiretroviral therapy during or after 2003, had a serum creatinine measurement at antiretroviral therapy initiation (baseline), and had at least 2 follow-up creatinine measurements taken ≥3 months apart. Patients with a baseline estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m2 were excluded. Chronic kidney disease was defined as 2 consecutive eGFR values ≤60 mL/min/1.73 m2 taken ≥3 months apart. Generalized estimating equations were used to identify factors associated with eGFR change. Competing risk regression adjusted for study site, age and sex, and cumulative incidence plots were used to evaluate factors associated with chronic kidney disease (CKD). Results: Of 2547 patients eligible for this analysis, tenofovir was being used by 703 (27.6%) at baseline. Tenofovir use, high baseline eGFR, advanced HIV disease stage, and low nadir CD4 were associated with a decrease in eGFR during follow-up. Chronic kidney disease occurred at a rate of 3.4 per 1000 patient/years. Factors associated with CKD were tenofovir use, old age, low baseline eGFR, low nadir CD4, and protease inhibitor use. Conclusions: There is an urgent need to enhance renal monitoring and management capacity among at-risk groups in Asia and improve access to less nephrotoxic antiretrovirals.
ISSN: 10991557
Appears in Collections:Scopus 2018

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