Temporal changes in renal glomerular function associated with the use of Tenofovir Disoproxil Fumarate in HIV-infected Nigerians

• Published in: West African journal of medicine Vol. 30; no. 3; pp. 164 - 168
• Main Authors: Agbaji, O O, Agaba, P A, Idoko, J A, Taiwo, B, Murphy, R, Kanki, P, Ekong, E
• Format: Journal Article
• Language: English
• Published: Nigeria 01.05.2011
• Subjects: Adenine - adverse effects; Adenine - analogs & derivatives; Adult; Aged; Anti-HIV Agents - adverse effects; Antiretroviral Therapy, Highly Active; Creatinine - blood; Female; Glomerular Filtration Rate - drug effects; HIV Infections - drug therapy; HIV Infections - physiopathology; HIV-1; Hospitals, Teaching; Humans; Male; Middle Aged; Nigeria; Organophosphonates - adverse effects; Retrospective Studies; Reverse Transcriptase Inhibitors - adverse effects; Tenofovir; Nigeria
• ISSN: 0189-160X

Reports of renal dysfunction in Tenofovir Disoproxil Fumarate (TDF)-treated HIV-1 infected patients have raised concerns about potential nephrotoxicity. To compare the effects on renal function of TDF-containing highly active anti-retroviral therapy (HAART) with a non-TDF-containing HAART. This was an observational study.Clinical and laboratory data of 186 HIV-1 infected adult Nigerians on first-line HAART for at least 48 weeks were reviewed. Eighty-four patients whose nucleos(t)ide reverse transcriptase inhibitor (NRTI) backbone included TDF were compared to 102 patients on other NRTI backbones. Creatinine clearance (CLcr) was estimated using the Cockcroft-Gault equation. Changes in serum creatinine and CLcr from the baseline for each patient were compared between the TDF-treated and the TDF-free patients. We also assessed the associations of other variables with change in CLcr... Baseline median serum creatinine (mmol/L) was 77 and 84 in the TDF-treated and TDF-free groups, respectively (p=0.59). Baseline median CLcr (mls/min) was 83 in the TDF-treated patients vs 78 in the TDF-free group. At 48 weeks, serum creatinine increased by 18.1% and 1.2% in the TDF-treated and TDF-free arms, respectively. There was a decrease of 4.8% in GFR in the TDF arm compared to a gain 5.1% in the TDF-free arm. Tenofovir Disoproxil Fumarate-containing HAART is associated with a slight decline in the medium term in CLcr compared with HAART regimens containing alternative Nucleosid(t) Reverse Transcriptase Inhibitors.