title: Increased risk of abnormal proximal renal tubular function with HIV infection and antiretroviral therapy.
abstract: Abnormal kidney function is common in the course of human immunodeficiency virus (HIV) infection. Here, we performed a cross-sectional analysis using 399 patients within the Aquitaine cohort (a hospital-based cohort of HIV-1-infected patients receiving routine clinical management) to estimate the prevalence of proximal renal tubular dysfunction (PRTD) associated with HIV infection. These patients did not differ statistically by sociodemographics, median age, years since HIV diagnosis, AIDS stage, or median CD4 cell count from the entire 3080 patient cohort. Antiretroviral therapy was received by 352 patients, with 256 given tenofovir (TDF); 325 had undetectable HIV plasma viral load, and 26 were diagnosed with PRTD. In multivariate analysis, significant independent associations were found between PRTD and age (odds ratio (OR) 1.28 per 5-year increase), atazanavir (OR 1.28 per year of exposure), and TDF (OR 1.23 per year) treatment. Among patients having received TDF-containing regimens over a 5-year period, PRTD remained significantly associated with TDF exposure when treatment was ongoing (OR 5.22) or had been discontinued (OR 11.49). Thus, cumulative exposure to TDF and/or atazanavir was associated with an increased risk of PRTD, with concern about its reversibility in patients with HIV.
authors.affiliation: Services de Maladies Infectieuses et Tropicales and COREVIH, Hôpital Pellegrin, CHU de Bordeaux, Université Bordeaux Segalen, Bordeaux, France. frederic.dauchy@chu-bordeaux.fr
authors.forename: Frédéric-Antoine
authors.initials: FA
authors.lastname: Dauchy
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lawson-Ayayi
authors.forename: Renaud
authors.initials: R
authors.lastname: de La Faille
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonnet
authors.forename: Claire
authors.initials: C
authors.lastname: Rigothier
authors.forename: Nadia
authors.initials: N
authors.lastname: Mehsen
authors.forename: Ghada
authors.initials: G
authors.lastname: Miremont-Salamé
authors.forename: Charles
authors.initials: C
authors.lastname: Cazanave
authors.forename: Carine
authors.initials: C
authors.lastname: Greib
authors.forename: Francois
authors.initials: F
authors.lastname: Dabis
authors.forename: Michel
authors.initials: M
authors.lastname: Dupon
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives; D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active; D000069446:Atazanavir Sulfate; D003430:Cross-Sectional Studies; D005198:Fanconi Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000254:growth & development / Q000472:pathogenicity; D006801:Humans; D007687:Kidney Tubules, Proximal / Q000187:drug effects* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009842:Oligopeptides / Q000009:adverse effects; D063065:Organophosphonates / Q000009:adverse effects; D015995:Prevalence; D011725:Pyridines / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D000068698:Tenofovir; D013997:Time Factors
chemical_list: D044966:Anti-Retroviral Agents; D009842:Oligopeptides; D063065:Organophosphonates; D011725:Pyridines; D000069446:Atazanavir Sulfate; D000068698:Tenofovir; D000225:Adenine