Tenofovir disoproxil fumarate (TDF) has been associated with renal insufficiency. Co-administration with boosted protease inhibitors (PIs), which increases its exposure, may further increase the risk of renal insufficiency

Currier, Judith

Hogg, Evelyn

Hosseinipour, Mina

Hughes, Michael D.

Lockman, Shahin

Mulenga, Lloyd

Mwafongo, Albert

Nkanaunena, Kondwani

Samaneka, Wadzanai

Siika, Abraham

Zheng, Yu

ObjectivesTenofovir disoproxil fumarate (TDF) has been associated with renal insufficiency. Co-administration with boosted protease inhibitors, which increases its exposure, may further increase the risk of renal insufficiency.MethodsWe compared the incidence of renal events among women taking TDF co-administered with lopinavir/ritonavir (LPV/r) versus those co-administering TDF with nevirapine (NVP). Renal events were defined as a confirmed drop in creatinine clearance associated with a serum creatinine grade 2 or higher, or that leading to treatment modification.ResultsOverall, 741 HIV-infected women were enrolled into the study. Of these, 24 (3.2%) had reportable renal events (18 in LPV/r arm, six in NVP arm). In multivariate analysis, renal events were significantly associated with the LPV/r arm [odds ratio (OR) 3.12, 95% confidence interval (CI) 1.21, 8.05; P = 0.019], baseline HIV-1 RNA (OR 2.65, 95% CI 1.23, 5.69 per 1 log10 copies/ml higher; P = 0.013) and baseline creatinine clearance (OR 0.83, 95% CI 0.70-0.98 per 10 ml/min higher; P = 0.030). In multivariate analysis evaluating renal events requiring treatment modification, only baseline HIV-1 RNA and creatinine clearance were significantly associated (OR 4.41, 95% CI 1.65, 11.78 per 1 log10 copies/ml higher; P = 0.003 and OR 0.80, 95% CI 0.64, 0.99 per 10 ml/min higher; P = 0.040, respectively).ConclusionThe rates of renal events were relatively low in the two treatment arms. However, patients taking TDF co-administered with LPV/r had significantly more renal events compared to those co-administered with NVP. Furthermore, higher baseline HIV RNA and lower creatinine clearance were associated with the development of renal insufficiency requiring treatment modification

Hughes, Michael D

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Renal events among women treated with tenofovir/emtricitabine in combination with either lopinavir/ritonavir or nevirapine

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https://cdr.lib.unc.edu/downloads/1257b0150

Renal events among women treated with tenofovir/emtricitabine in combination with either lopinavir/ritonavir or nevirapine

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eScholarship - University of California

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