Author(s): Chaisiri K, Bowonwatanuwong C, Kasettratat N, Kiertiburanakul S
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Abstract OBJECTIVES: we aimed at determining the incidence and factors for TDF-associated renal function decline among Thai HIV-infected patients. METHODS: retrospective and prospective cohort studies were conducted. We enrolled HIV-infected adults who had initiated TDF. Renal function decline that was defined by a decrease of 25\% in glomerular filtration rate (GFR) from the baseline. Factors associated with the renal function decline were determined. RESULTS: a total of 405 patients with a median (IQR) body weight of 56.5 (50.5-65.0) kg were enrolled. All but four (99\%) were antiretroviral treatment-experience patients. A median (IQR) duration of receiving TDF was 16 (8-21) months. Of these, 78 (19.3\%) patients had a 25\% decrease in GFR with the incidence rate of 16.2 per 100 person-years. By Kaplan-Meier survival analysis, median time to a 25\% decrease in GFR was 28 [95\% confidence interval (CI) 25.2-30.8] months. By multiple logistic regression, lower body weight [odds ratio (OR) 1.15 per 5 kg, 95\% CI 1.00-1.33], lower body mass index (BMI) (OR 2.26 per 1 kg/m(2), 95\% CI 1.74-2.94), baseline GFR (OR 1.62 per 10 ml/min/1.73m(2), 95\% CI 1.39-1.88), protease inhibitor (OR 2.12, 95\% CI 1.15-3.92), and nephrotoxic drug (OR 3.16, 95\% CI 1.44-6.98) were statistically significant factors associated with a 25\% decrease in GFR. CONCLUSIONS: the study revealed high incidence of TDF-associated renal function decline among patients with low-body weight and BMI. Additional risk factors were baseline GFR, receiving protease inhibitor, and nephrotoxic drugs. Close monitoring of renal function is warranted among patients with these risk factors.
This article was published in Curr HIV Res
and referenced in Journal of AIDS & Clinical Research