Use of Contemporary Protease Inhibitors and Risk of Incident Chronic Kidney Disease in Persons With Human Immunodeficiency Virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study
It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors. Participants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last...
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| Published in: | The Journal of infectious diseases Vol. 220; no. 10; p. 1629 |
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| Main Authors: | , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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08.10.2019
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| ISSN: | 1537-6613, 1537-6613 |
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| Abstract | It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors.
Participants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last visit plus 6 months, or 1 February 2016. Adjusted Poisson regression was used to assess associations between CKD and the use of ritonavir-boosted atazanavir (ATV/r) or ritonavir-boosted darunavir (DRV/r).
The incidence of CKD (10.0/1000 person-years of follow-up; 95% confidence interval, 9.5-10.4/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r, but the relation was less clear for DRV/r. After adjustment, only exposure to ATV/r (adjusted incidence rate ratio, 1.4; 95% confidence interval, 1.2-1.6), but not exposure to DRV/r (1.0; .8-1.3), remained significantly associated with CKD.
While DRV/r use was not significantly associated with CKD an increasing incidence with longer ATV/r use was confirmed. |
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| AbstractList | It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors.BACKGROUNDIt is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors.Participants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last visit plus 6 months, or 1 February 2016. Adjusted Poisson regression was used to assess associations between CKD and the use of ritonavir-boosted atazanavir (ATV/r) or ritonavir-boosted darunavir (DRV/r).METHODSParticipants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last visit plus 6 months, or 1 February 2016. Adjusted Poisson regression was used to assess associations between CKD and the use of ritonavir-boosted atazanavir (ATV/r) or ritonavir-boosted darunavir (DRV/r).The incidence of CKD (10.0/1000 person-years of follow-up; 95% confidence interval, 9.5-10.4/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r, but the relation was less clear for DRV/r. After adjustment, only exposure to ATV/r (adjusted incidence rate ratio, 1.4; 95% confidence interval, 1.2-1.6), but not exposure to DRV/r (1.0; .8-1.3), remained significantly associated with CKD.RESULTSThe incidence of CKD (10.0/1000 person-years of follow-up; 95% confidence interval, 9.5-10.4/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r, but the relation was less clear for DRV/r. After adjustment, only exposure to ATV/r (adjusted incidence rate ratio, 1.4; 95% confidence interval, 1.2-1.6), but not exposure to DRV/r (1.0; .8-1.3), remained significantly associated with CKD.While DRV/r use was not significantly associated with CKD an increasing incidence with longer ATV/r use was confirmed.CONCLUSIONWhile DRV/r use was not significantly associated with CKD an increasing incidence with longer ATV/r use was confirmed. It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors. Participants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last visit plus 6 months, or 1 February 2016. Adjusted Poisson regression was used to assess associations between CKD and the use of ritonavir-boosted atazanavir (ATV/r) or ritonavir-boosted darunavir (DRV/r). The incidence of CKD (10.0/1000 person-years of follow-up; 95% confidence interval, 9.5-10.4/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r, but the relation was less clear for DRV/r. After adjustment, only exposure to ATV/r (adjusted incidence rate ratio, 1.4; 95% confidence interval, 1.2-1.6), but not exposure to DRV/r (1.0; .8-1.3), remained significantly associated with CKD. While DRV/r use was not significantly associated with CKD an increasing incidence with longer ATV/r use was confirmed. |
| Author | Phillips, Andrew Ross, Mike Morlat, Phillip Mocroft, Amanda Reiss, Peter Ryom, Lene D'Arminio Monforte, Antonella Dilling Lundgren, Jens El-Sadr, Wafaa De Wit, Stephane Fontas, Eric Ingrid Hatleberg, Camilla Sabin, Caroline Kirk, Ole Andreas Fux, Christoph Law, Matthew |
| Author_xml | – sequence: 1 givenname: Lene surname: Ryom fullname: Ryom, Lene organization: Rigshospitalet, University of Copenhagen, CHIP, Department of Infectious Diseases, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen, Denmark – sequence: 2 givenname: Jens surname: Dilling Lundgren fullname: Dilling Lundgren, Jens organization: Rigshospitalet, University of Copenhagen, CHIP, Department of Infectious Diseases, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen, Denmark – sequence: 3 givenname: Peter surname: Reiss fullname: Reiss, Peter organization: HIV Monitoring Foundation, Amsterdam, The Netherlands – sequence: 4 givenname: Ole surname: Kirk fullname: Kirk, Ole organization: Rigshospitalet, University of Copenhagen, CHIP, Department of Infectious Diseases, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen, Denmark – sequence: 5 givenname: Matthew surname: Law fullname: Law, Matthew organization: Kirby Institute, University of New South Wales Sydney, Australia – sequence: 6 givenname: Mike surname: Ross fullname: Ross, Mike organization: Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, and – sequence: 7 givenname: Phillip surname: Morlat fullname: Morlat, Phillip organization: Université de Bordeaux, INSERM – sequence: 8 givenname: Christoph surname: Andreas Fux fullname: Andreas Fux, Christoph organization: Clinic for Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland – sequence: 9 givenname: Eric surname: Fontas fullname: Fontas, Eric organization: Department of Public Health, Nice University Hospital, France – sequence: 10 givenname: Stephane surname: De Wit fullname: De Wit, Stephane organization: Division of Infectious Diseases, Saint Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium – sequence: 11 givenname: Antonella surname: D'Arminio Monforte fullname: D'Arminio Monforte, Antonella organization: Dipartimento di Scienze della Salute, Clinica di Malattie Infettive e Tropicali, Azienda Ospedaliera-Polo Universitario San Paolo, Milan, Italy – sequence: 12 givenname: Wafaa surname: El-Sadr fullname: El-Sadr, Wafaa organization: ICAP at Columbia University and Harlem Hospital, New York – sequence: 13 givenname: Andrew surname: Phillips fullname: Phillips, Andrew organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London, London, United Kingdom – sequence: 14 givenname: Camilla surname: Ingrid Hatleberg fullname: Ingrid Hatleberg, Camilla organization: Rigshospitalet, University of Copenhagen, CHIP, Department of Infectious Diseases, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen, Denmark – sequence: 15 givenname: Caroline surname: Sabin fullname: Sabin, Caroline organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London, London, United Kingdom – sequence: 16 givenname: Amanda surname: Mocroft fullname: Mocroft, Amanda organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London, London, United Kingdom |
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| CitedBy_id | crossref_primary_10_1080_17425255_2025_2538885 crossref_primary_10_1097_QAD_0000000000002516 crossref_primary_10_1016_j_kint_2024_04_010 crossref_primary_10_1080_17512433_2024_2365826 crossref_primary_10_1093_jac_dkaa299 crossref_primary_10_1097_COH_0000000000000703 crossref_primary_10_1111_hiv_13019 crossref_primary_10_1016_j_kint_2022_06_021 crossref_primary_10_1371_journal_pone_0261367 crossref_primary_10_1007_s15006_020_0642_1 crossref_primary_10_1016_j_ijantimicag_2023_106897 crossref_primary_10_1093_jpids_piae054 |
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| Copyright | The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. |
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| Keywords | HIV nephrotoxicity atazanavir protease inhibitors adverse drug effect darunavir CKD |
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| Snippet | It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors.... It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease... |
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| SubjectTerms | Adult Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Female Follow-Up Studies HIV Infections - complications HIV Infections - drug therapy HIV Protease Inhibitors - adverse effects HIV Protease Inhibitors - therapeutic use Humans Incidence Male Middle Aged Prospective Studies Renal Insufficiency, Chronic - chemically induced Renal Insufficiency, Chronic - epidemiology Risk Assessment |
| Title | Use of Contemporary Protease Inhibitors and Risk of Incident Chronic Kidney Disease in Persons With Human Immunodeficiency Virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study |
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