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Title: | Renal dysfunction during tenofovir use in a regional cohort of HIV-infected individuals in the Asia-Pacific | Authors: | Tanuma J. Jiamsakul A. Makane A. Avihingsanon A. Ng O.T. Kiertiburanakul S. Chaiwarith R. Kumarasamy N. Van Nguyen K. Pham T.T. Lee M.P. Ditangco R. Merati T.P. Choi J.Y. Wong W.W. Kamarulzaman A. Yunihastuti E. Sim B.L. Ratanasuwan W. Kantipong P. Zhang F. Mustafa M. Saphonn V. Pujari S. Sohn A.H. Mean C.V. Saphonn V. Vohith K. Zhang F.J. Zhao H.X. Han N. Li P.C.K. Lam W. Chan Y.T. Wong K.H. Saghayam S. Ezhilarasi C. Joshi K. Wirawan D.N. Yuliana F. Imran D. Widhani A. Oka S. Nishijima T. Na S. Kim J.M. Gani Y.M. David R. Omar S.F.S. Ponnampalavanar S. Azwa I. Huda N. Ong L.Y. Uy E. Bantique R. Ku W.W. Wu P.C. Lim P.L. Lee L.S. Ohnmar P.S. Phanuphak P. Ruxrungtham K. Chusut P. Sirivichayakul S. Sungkanuparph S. Chumla L. Sanmeema N. Chaiwarith R. Sirisanthana T. Kotarathititum W. Praparattanapan J. Kantipong P. Kambua P. Sriondee R. Bui V.H. Cao T.T. Cuong D.D. Ha H.L. Durier N. Petersen B. Singtoroj T. Cooper D.A. Law M.G. Boettiger D.C. |
Keywords: | creatinine proteinase inhibitor tenofovir anti human immunodeficiency virus agent creatinine tenofovir adult aging Article Asia cohort analysis creatinine blood level drug efficacy estimated glomerular filtration rate female human Human immunodeficiency virus infected patient Human immunodeficiency virus infection incidence kidney dysfunction major clinical study male middle aged Pacific islands prevalence proportional hazards model renal protection risk factor blood chemically induced drug effects factual database glomerulus filtration rate HIV Infections kidney kidney disease pathophysiology Poisson distribution prospective study Adult Anti-HIV Agents Creatinine Databases, Factual Female Glomerular Filtration Rate HIV Infections Humans Kidney Kidney Diseases Male Middle Aged Poisson Distribution Proportional Hazards Models Prospective Studies Risk Factors Tenofovir |
Issue Date: | 2016 | Citation: | Tanuma J., Jiamsakul A., Makane A., Avihingsanon A., Ng O.T., Kiertiburanakul S., Chaiwarith R., Kumarasamy N., Van Nguyen K., Pham T.T., Lee M.P., Ditangco R., Merati T.P., Choi J.Y., Wong W.W., Kamarulzaman A., Yunihastuti E., Sim B.L., Ratanasuwan W., Kantipong P., Zhang F., Mustafa M., Saphonn V., Pujari S., Sohn A.H., Mean C.V., Saphonn V., Vohith K., Zhang F.J., Zhao H.X., Han N., Li P.C.K., Lam W., Chan Y.T., Wong K.H., Saghayam S., Ezhilarasi C., Joshi K., Wirawan D.N., Yuliana F., Imran D., Widhani A., Oka S., Nishijima T., Na S., Kim J.M., Gani Y.M., David R., Omar S.F.S., Ponnampalavanar S., Azwa I., Huda N., Ong L.Y., Uy E., Bantique R., Ku W.W., Wu P.C., Lim P.L., Lee L.S., Ohnmar P.S., Phanuphak P., Ruxrungtham K., Chusut P., Sirivichayakul S., Sungkanuparph S., Chumla L., Sanmeema N., Chaiwarith R., Sirisanthana T., Kotarathititum W., Praparattanapan J., Kantipong P., Kambua P., Sriondee R., Bui V.H., Cao T.T., Cuong D.D., Ha H.L., Durier N., Petersen B., Singtoroj T., Cooper D.A., Law M.G., Boettiger D.C. (2016). Renal dysfunction during tenofovir use in a regional cohort of HIV-infected individuals in the Asia-Pacific. PLoS ONE 11 (8) : e0161562. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0161562 | Rights: | Attribution 4.0 International | Abstract: | Background: In resource-limited settings, routine monitoring of renal function during antiretroviral therapy (ART) has not been recommended. However, concerns for tenofovir disoproxil fumarate (TDF)-related nephrotoxicity persist with increased use. Methods: We investigated serum creatinine (S-Cr) monitoring rates before and during ART and the incidence and prevalence of renal dysfunction after starting TDF by using data from a regional cohort of HIV-infected individuals in the Asia-Pacific. Time to renal dysfunction was defined as time from TDF initiation to the decline in estimated glomerular filtration rate (eGFR) to <60 ml/min/1.73m2 with >30% reduction from baseline using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation or the decision to stop TDF for reported TDF-nephrotoxicity. Predictors of S-Cr monitoring rates were assessed by Poisson regression and risk factors for developing renal dysfunction were assessed by Cox regression. Results: Among 2,425 patients who received TDF, S-Cr monitoring rates increased from 1.01 to 1.84 per person per year after starting TDF (incidence rate ratio 1.68, 95%CI 1.62-1.74, p <0.001). Renal dysfunction on TDF occurred in 103 patients over 5,368 person-years of TDF use (4.2%; incidence 1.75 per 100 person-years). Risk factors for developing renal dysfunction included older age (>50 vs. ?30, hazard ratio [HR] 5.39, 95%CI 2.52-11.50, p <0.001; and using PI-based regimen (HR 1.93, 95%CI 1.22-3.07, p = 0.005). Having an eGFR prior to TDF (pre-TDF eGFR) of ?60 ml/min/1.73m2 showed a protective effect (HR 0.38, 95%CI, 0.17-0.85, p = 0.018). Conclusions: Renal dysfunction on commencing TDF use was not common, however, older age, lower baseline eGFR and PI-based ART were associated with higher risk of renal dysfunction during TDF use in adult HIV-infected individuals in the Asia-Pacific region. © 2016 Tanuma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | Source Title: | PLoS ONE | URI: | https://scholarbank.nus.edu.sg/handle/10635/161559 | ISSN: | 19326203 | DOI: | 10.1371/journal.pone.0161562 | Rights: | Attribution 4.0 International |
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