alexa Renal Dysfunction among HIV-infected Patients on Tenofo
ISSN 2155-6113

Journal of AIDS & Clinical Research
Open Access

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Research Article

Renal Dysfunction among HIV-infected Patients on Tenofovir-Based Antiretroviral Therapy at Ronald Ross Hospital in Zambia

Wantakisha E1*, Chongwe G2, Munkombwe D2and Michelo C2

1Ronald Ross General Hospital, Ministry of Health, Mufulira, Zambia

2Department of Epidemiology, School of Public Health, University of Zambia, Lusaka, Zambia

*Corresponding Author:
Enock Wantakisha
Department of Pathology and Microbiology
Ronald Ross General Hospital, PB 40987 Mufulira
Zambia
Tel: 0212411722, 0212411722
Fax: 410166
E-mail: [email protected]

Received date: December 16, 2016; Accepted date: January 02, 2017; Published date: January 09, 2017

Citation: Wantakisha E, Chongwe G, Munkombwe D, Michelo C (2017) Renal Dysfunction among HIV-infected Patients on Tenofovir-Based Antiretroviral Therapy at Ronald Ross Hospital in Zambia. J AIDS Clin Res 8:651. doi:10.4172/2155-6113.1000651

Copyright: © 2017 Wantakisha E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

 

Abstract

Objective: Tenofovir Disoproxil Fumerate (TDF) is contraindicated for use in HIV infected patients when creatinine clearance (CrCl) is below 50ml/min. We determined prevalence and factors associated with renal dysfunction at 18 months follow up in adult HIV positive patients on TDF-based antiretroviral therapy (ART). Methods: We conducted a cross sectional study of 445 HIV positive patients’ records on a TDF-regimen at Ronald Ross General Hospital in Zambia. Patient’s records in data management software (SMARTCARE) from 2008 to 2014 were reviewed to determine proportions of patients on TDF developing renal dysfunction. We estimated glomerular filtration rate (GFR) by creatinine clearance using the Cockcroft-Gault formula to determine renal dysfunction. CrCl level ≤ 50 ml/min indicated renal dysfunction. Multiple logistic regression was used to determine factors associated with renal dysfunction. Results: At baseline (n=429), median age of patients was 35 years (IQR 30, 42), median CrCl level 106.2 ml/ min (IQR: 79.9, 127.8). At 18 months, median CrCl 102 ml/min (IQR: 81.6, 123.2) which remained within normal physiological range (88-137 ml/min). Point prevalence of renal dysfunction was 18.6% (95% CI; 0.2-28.3). Multivariable analysis showed that ages <50 years than older (AOR: 0.06 95%CI 0.01-0.27; p<0.0001), and those with higher CD4+ cell count ≥ 350 cells/uL than lower (AOR: 0.19 95%CI 0.03-0.21; P=0.014) had lower likelihood of renal dysfunction. Conclusion: We found a high prevalence of renal dysfunction among HIV positive adults on tenofovir-based therapy. This was concentrated in older patients with low CD4+ cell counts suggesting a need for close renal function monitoring in this population when initiating tenofovir-based treatment.

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