Recovery of renal function after early versus late switching of tenofovir disoproxil fumarate in people living with HIV with renal insufficiency
Issued Date
2022-03-01
Resource Type
ISSN
09564624
eISSN
17581052
Scopus ID
2-s2.0-85125085765
Pubmed ID
35143730
Journal Title
International Journal of STD and AIDS
Volume
33
Issue
4
Start Page
391
End Page
396
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of STD and AIDS Vol.33 No.4 (2022) , 391-396
Suggested Citation
Suppadungsuk S. Recovery of renal function after early versus late switching of tenofovir disoproxil fumarate in people living with HIV with renal insufficiency. International Journal of STD and AIDS Vol.33 No.4 (2022) , 391-396. 396. doi:10.1177/09564624221076632 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86075
Title
Recovery of renal function after early versus late switching of tenofovir disoproxil fumarate in people living with HIV with renal insufficiency
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: Although many guidelines recommend switching tenofovir disoproxil fumarate (TDF) to other antiretroviral agents if there is a progressive decline in the estimated glomerular filtration rate (eGFR) not explained by other causes, a definite cut-point of the eGFR for TDF switching is not known. Methods: A cohort study was conducted among people living with HIV (PLHIV) who switched from TDF to other agents due to declined eGFR. Participants were categorized according to the eGFR at TDF switching: early-switch (eGFR ≥ 60 mL/min/1.73 m2) and late-switch (eGFR < 60 mL/min/1.73 m2) groups. Binary logistic regression was used to determine factors associated with complete recovery of renal function. Results: Of 141 participants, mean age was 54.2 ± 12.2 years and 74.5% were male. Median duration of TDF use was 5.2 years. Mean eGFR at the time of TDF switching was 72.4 ± 13.7 mL/min/1.73 m2 in the early-switch group and 47.0 ± 14.8 mL/min/1.73 m2 in the late-switch group. Six months after TDF switching, mean eGFR significantly increased to 84.2 ± 13.5 (p =.001) and 58.5 ± 13.2 mL/min/1.73 m2 (p <.001) in early-switch and late-switch groups, respectively. At 12 months after TDF switching, 44.4% of participants in early-switch group and 2.3% of participants in late-switch group had eGFR recovery to ≥ 90 mL/min/1.73 m2 (p <.001). Multivariate analysis showed that only early switching (vs late switching) of TDF was associated with complete recovery of renal function at 12 months after TDF switching [OR, 7.542; 95% CI, 2.441–11.119; p =.028]. Conclusions: In PLHIV with TDF-associated renal insufficiency, eGFR significantly recovers after switching TDF to other agents. Early TDF switching has a higher chance of complete recovery of renal function.