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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Tenofovir use is associated with a reduction in calculated glomerular filtration rates in the Swiss HIV Cohort Study
Antiviral Therapy, Volume 12, No. 8, Year 2007
Notification
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Description
Background: A growing number of case reports have described tenofovir (TDF)-related proximal renal tubulopathy and impaired calculated glomerular filtration rates (cGFR). We assessed TDF-associated changes in cGFR in a large observational HIV cohort. Methods: We compared treatment-naive patients or patients with treatment interruptions ≥12 months starting either a TDF-based combination antiretroviral therapy (cART) (n=363) or a TDF-sparing regime (n=715). The predefined primary endpoint was the time to a 10 ml/min reduction in cGFR, based on the Cockcroft-Gault equation, confirmed by a follow-up measurement at least 1 month later. In sensitivity analyses, secondary endpoints including calculations based on the modified diet in renal disease (MDRD) formula were considered. Endpoints were modelled using pre-specified covariates in a multiple Cox proportional hazards model. Results: Two-year event-free probabilities were 0.65 (95% confidence interval [CI] 0.58-0.72) and 0.80 (95% CI 0.76-0.83) for patients starting TDF-containing or TDF-sparing cART, respectively. In the multiple Cox model, diabetes mellitus (hazard ratio [HR]=2.34 [95% CI 1.24-4.42]), higher baseline cGFR (HR=1.03 [95% CI 1.02-1.04] by 10 ml/min), TDF use (HR=1.84 [95% CI 1.35-2.51]) and boosted protease inhibitor use (HR=1.71 [95% CI 1.30-2.24]) significantly increased the risk for reaching the primary endpoint. Sensitivity analyses showed high consistency. Conclusion: There is consistent evidence for a significant reduction in cGFR associated with TDF use in HIV-infected patients. Our findings call for a strict monitoring of renal function in long-term TDF users with tests that distinguish between glomerular dysfunction and proximal renal tubulopathy, a known adverse effect of TDF. © 2007 International Medical Press.
Authors & Co-Authors
Wolbers, Marcel
Switzerland, Basel
Basel Institut Für Klinische Epidemiologie Und Biostatistik
Bucher, Heíner C.C.
Switzerland, Basel
Basel Institut Für Klinische Epidemiologie Und Biostatistik
Switzerland, Basel
Universitätsspital Basel
Hirschel, B. J.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Opravil, Milos
Switzerland, Zurich
Universitatsspital Zurich
Vernazza, Pietro Luigi
Switzerland, St Gallen
Kantonsspital St.gallen
Cavassini, Matthias L.
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Bernasconi, Enos
Switzerland, Lugano
Hospital of Lugano
Elzi, Luigia
Switzerland, Basel
Universitätsspital Basel
Furrer, Hansjakob Jackob
Switzerland, Bern
University Hospital Bern
Battegay, Manuel
Unknown Affiliation
Bernasconi, Enos
Unknown Affiliation
Böni, Jürg
Unknown Affiliation
Bucher, Heiner C.
Unknown Affiliation
Bürgisser, Ph
Unknown Affiliation
Cattacin, Sandro
Unknown Affiliation
Cavassini, Matthias
Unknown Affiliation
Dubs, Rolf W.
Unknown Affiliation
Egger, Matthias
Unknown Affiliation
Erb, Peter
Unknown Affiliation
Fischer, Marek
Unknown Affiliation
Flepp, Markus J.
Unknown Affiliation
Fontana, Adriano
Unknown Affiliation
Francioli, Patrick B.
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Furrer, Hansjakob
Unknown Affiliation
Fux, Christoph Andreas
Unknown Affiliation
Gorgievski, Meri
Unknown Affiliation
Günthard, Hüldrych Fritz
Unknown Affiliation
Hirschel, B.
Unknown Affiliation
Hösli, Irene Mathilde
Unknown Affiliation
Kahlert, Christian R.
Unknown Affiliation
Kaiser, Laurent K.
Unknown Affiliation
Karrer, Urs
Unknown Affiliation
Keiser, Olivia
Unknown Affiliation
Kind, Christian H.
Unknown Affiliation
Klimkait, Thomas
Unknown Affiliation
Ledergerber, Bruno
Unknown Affiliation
Martinez, Begogna
Unknown Affiliation
Müller, Nicolas J.
Unknown Affiliation
Nadal, David
Unknown Affiliation
Paccaud, Fred Michel
Unknown Affiliation
Pantaleo, Giuseppe P.
Unknown Affiliation
Perrin, Luc Henri
Unknown Affiliation
Piffaretti, Jean Claude L.
Unknown Affiliation
Rauch, Andri
Unknown Affiliation
Rickenbach, Martin
Unknown Affiliation
Rudin, Christoph
Unknown Affiliation
Schmid, Patrick
Unknown Affiliation
Schültze, Detlev
Unknown Affiliation
Schüpbach, Jörg Rg
Unknown Affiliation
Speck, Roberto F.
Unknown Affiliation
Taffé, Patrick
Unknown Affiliation
Tarr, Philip E.
Unknown Affiliation
Telenti, Amalio
Unknown Affiliation
Trkola, Alexandra
Unknown Affiliation
Vernazza, Pietro L.
Unknown Affiliation
Weber, Rainer
Unknown Affiliation
Yerly, Sabine T.B.D.
Unknown Affiliation
Statistics
Citations: 110
Authors: 57
Affiliations: 8
Identifiers
ISSN:
13596535
Research Areas
Environmental
Infectious Diseases
Noncommunicable Diseases
Study Design
Cohort Study
Study Approach
Quantitative