Renal function in Tenofovir-exposed and Tenofovir-unexposed patients receiving highly active antiretroviral therapy in the HIV Outpatient Study.
BACKGROUND
Cases of renal dysfunction have been reported in HIV-infected patients taking tenofovir (TDF), but few large studies have examined population-level changes in renal function associated with TDF use in patients in routine care.


METHODS
The authors analyzed data from participants in the HIV Outpatient Study (HOPS) who had normal baseline renal function and received >1 month of TDF-containing (n = 593) or TDF-sparing (n = 521) HAART after November 1, 2001.


RESULTS
Median baseline CrCl estimated by Cockcroft-Gault equation was 106 mL/min for TDF-exposed and 110 mL/min for TDF-unexposed patients (P = 0.06). In multivariable analyses, 1-year changes in CrCl (mL/min) from baseline were -5.7 among TDF-exposed and 2.6 among TDF-unexposed (P < 0.001). Incident renal disease was diagnosed in 7 TDF-exposed and 3 TDF-unexposed patients.


CONCLUSIONS
In this large cohort of HIV-infected outpatients, use of TDF-containing HAART was associated with modest decreases in CrCl during the first year, but not with frequent, clinically significant renal toxicity.
Young
Benjamin
B
Rose Medical Center, Denver, CO 80220, USA. denveridc@aol.com
Buchacz
Kate
K
Baker
Rose K
RK
Moorman
Anne C
AC
Wood
Kathy C
KC
Chmiel
Joan
J
Brooks
John T
JT
D000225:Adenine / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D003404:Creatinine; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D063065:Organophosphonates / Q000627:therapeutic use; D010045:Outpatients; D000068698:Tenofovir
D019380:Anti-HIV Agents; D063065:Organophosphonates; D000068698:Tenofovir; D003404:Creatinine; D000225:Adenine