Publication: Renal impairment in HIV-1 infected patients receiving antiretroviral regimens including tenofovir in a resource-limited setting
Issued Date
2011-08-08
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ISSN
01251562
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2-s2.0-79961068843
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Mahidol University
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SCOPUS
Bibliographic Citation
Southeast Asian Journal of Tropical Medicine and Public Health. Vol.42, No.3 (2011), 643-650
Suggested Citation
Weerawat Manosuthi, Wisit Prasithsirikul, Preecha Tantanathip, Sukanya Chimsuntorn, Samruay Nilkamhang, Somnuek Sungkanuparph Renal impairment in HIV-1 infected patients receiving antiretroviral regimens including tenofovir in a resource-limited setting. Southeast Asian Journal of Tropical Medicine and Public Health. Vol.42, No.3 (2011), 643-650. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/12387
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Title
Renal impairment in HIV-1 infected patients receiving antiretroviral regimens including tenofovir in a resource-limited setting
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Abstract
A retrospective cohort study was conducted among HIV-1 infected patients taking tenofovir as part of an anti-HIV drug regimen in a resourcelimited setting in Thailand. One hundred thirty patients with a mean±SD age of 39.7±7.4 years, of whom 55% were male, were included in the study. Fifty-eight (45%), 48 (37%), and 24 (18%) patients concurrently received nevirapine-based, efavirenz-based, and protease inhibitor (PI)-based regimens, respectively. The median (IQR) value for serum creatinine was 0.8 (0.6-0.9) mg/dl, for eGFR was 103 (96-120) ml/min/1.73 m 2 and for CD4 was 302 (194-511) cells/mm 3 at the time of tenofovir initiation. At 3-6 months, the median (IQR) eGFR was 100 (88-117) ml/min/1.73 m 2 (p=0.002, compared to baseline). The proportions of patients with an estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73 m 2 at baseline and 3-6 months were 0% and 2%, respectively (p < 0.001). At 6-months follow-up, 2 patients (1.4%) were diagnosed with acute renal failure at 3 weeks and 9 weeks after tenofovir use, respectively. Both patients received a boosted PI in the regimen. Overall, the incidence of acute renal failure was 0.26 per 100 person-months. Renal function progressed to irreversible renal failure in one patient. In summary, tenofovir-associated renal impairment is not uncommon in a real-life practice. This report highlights the potentially irreversible adverse effect of this agent, particularly in patients with vulnerable kidneys and concomitant use of tenofovir and boosted PI.