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

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Název: Renal function in patients with HIV starting therapy with tenofovir and either efavirenz, lopinavir or atazanavir.
Autoři: Young, J., Schäfer, J., Fux, C.A., Furrer, H., Bernasconi, E., Vernazza, P., Calmy, A., Cavassini, M., Weber, R., Battegay, M., Bucher, H.C.
Přispěvatelé: Swiss HIV Cohort Study, 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.
Rok vydání: 2025
Sbírka: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Témata: Adenine/adverse effects, Adenine/analogs & derivatives, Adult, Benzoxazines/adverse effects, Drug Therapy, Combination/adverse effects, 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
Popis: 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.
Druh dokumentu: article in journal/newspaper
Jazyk: English
ISSN: 1473-5571
Relation: AIDS; https://iris.unil.ch/handle/iris/242272; serval:BIB_E49D4C7F0E9D; 000301333000006
DOI: 10.1097/QAD.0b013e32834f337c
Dostupnost: https://iris.unil.ch/handle/iris/242272
https://doi.org/10.1097/QAD.0b013e32834f337c
Přístupové číslo: edsbas.78F0D930
Databáze: BASE
Popis
Abstrakt: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.
ISSN:14735571
DOI:10.1097/QAD.0b013e32834f337c