Renal function in patients with HIV starting therapy with tenofovir and either efavirenz, lopinavir or atazanavir.

Details

Serval ID
serval:BIB_E49D4C7F0E9D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Renal function in patients with HIV starting therapy with tenofovir and either efavirenz, lopinavir or atazanavir.
Journal
Aids
Author(s)
Young J., Schäfer J., Fux C.A., Furrer H., Bernasconi E., Vernazza P., Calmy A., Cavassini M., Weber R., Battegay M., Bucher H.C.
Working group(s)
Swiss HIV Cohort Study
Contributor(s)
Barth J., Battegay M., Bernasconi E., Böni J., Bucher HC., Burton-Jeangros C., Calmy A., Cavassini M., Cellerai C., Egger M., Elzi L., Fehr J., Fellay J., Flepp M., Francioli P., Furrer H., Fischer M., Fux CA., Gorgievski M., Günthard H., Haerry D., Hasse B., Hirsch HH., Hirschel B., Hösli I., Kahlert C., Kaiser L., Keiser O., Kind C., Klimkait T., Kovari T., Ledergerber B., Martinetti G., Martinez de Tejada B., Metzner K., Müller N., Nadal D., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schöni-Affolter F., Schüpbach J., Speck R., Taffé P., Tarr P., Telenti A., Trkola A., Vernazza P., Weber R., Yerly S.
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Publication state
Published
Issued date
2012
Volume
26
Number
5
Pages
567-575
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Tenofovir is associated with reduced renal function, but it is not clear whether there is a greater decline in renal function when tenofovir is co-administered with a boosted protease inhibitor rather than with a nonnucleoside reverse transcriptase inhibitor (NNRTI).
METHODS: We calculated the estimated glomerular filtration rate (eGFR) for patients in the Swiss HIV Cohort Study. We estimated the difference in eGFR over time between first therapies containing tenofovir and either the NNRTI efavirenz or the protease inhibitors lopinavir (LPV/r) or atazanavir (ATV/r), both boosted with ritonavir.
RESULTS: Patients on a first therapy of tenofovir co-administered with efavirenz (n  = 484), LPV/r (n = 269) and ATV/r (n =  187) were followed for a median of 1.7, 1.2 and 1.3 years, respectively. Relative to tenofovir and efavirenz, the estimated difference in eGFR for tenofovir and LPV/r was -2.6 ml/min per 1.73 m [95% confidence interval (CI) -7.3 to 2.2) during the first 6 months of therapy, then followed by a difference of 0.0 ml/min per 1.73 m (95% CI -1.1 to 1.1) for each additional 6 months of therapy. Relative to tenofovir and efavirenz, the estimated difference in eGFR for tenofovir and ATV/r was -7.6 ml/min per 1.73 m (95% CI -11.8 to -3.4) during the first 6 months of therapy, then followed by a difference of -0.5 ml/min per 1.73 m (95% CI -1.6 to 0.7) for each additional 6 months of therapy.
CONCLUSION: Tenofovir with either boosted protease inhibitor leads to a greater initial decline in eGFR than tenofovir with efavirenz; this decline may be worse with ATV/r than with LPV/r.
Keywords
Adenine/adverse effects, Adenine/analogs & derivatives, Adult, Benzoxazines/adverse effects, Drug Therapy, Combination/adverse effects, Drug Therapy, Combination/methods, Female, Glomerular Filtration Rate/drug effects, HIV Infections/drug therapy, HIV Protease Inhibitors/administration & dosage, HIV Protease Inhibitors/adverse effects, Humans, Kidney/drug effects, Kidney/physiopathology, Lopinavir/adverse effects, Male, Middle Aged, Oligopeptides/adverse effects, Organophosphonates/adverse effects, Pyridines/adverse effects, Reverse Transcriptase Inhibitors/administration & dosage, Reverse Transcriptase Inhibitors/adverse effects, Ritonavir/adverse effects, Treatment Outcome
Pubmed
Web of science
Create date
01/04/2012 13:42
Last modification date
20/08/2019 16:08
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