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
Main Authors: Ryom, Lene, Dilling Lundgren, Jens, Reiss, Peter, Kirk, Ole, Law, Matthew, Ross, Mike, Morlat, Phillip, Andreas Fux, Christoph, Fontas, Eric, De Wit, Stephane, D'Arminio Monforte, Antonella, El-Sadr, Wafaa, Phillips, Andrew, Ingrid Hatleberg, Camilla, Sabin, Caroline, Mocroft, Amanda
Format: Journal Article
Language:English
Published: United States 08.10.2019
Subjects:
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
HIV
nephrotoxicity
atazanavir
protease inhibitors
adverse drug effect
darunavir
CKD
ISSN:1537-6613, 1537-6613
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Summary: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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ISSN:1537-6613
1537-6613
DOI:10.1093/infdis/jiz369