title: Evolution of glomerular filtration rate in HIV-infected, HIV-HBV-coinfected and HBV-infected patients receiving tenofovir disoproxil fumarate.
abstract: We aimed to compare the evolution of estimated glomerular filtration rate (eGFR) in HIV-, HIV-HBV- and HBV-infected patients treated with tenofovir disoproxil fumarate (TDF). Three groups of patients receiving TDF > 12 months were recruited: 194 HIV-infected patients, 85 HIV-HBV-coinfected patients and 50 HBV-infected patients. eGFR was estimated using the Modification of the Diet in Renal Disease (MDRD) equation. Multivariate regression models were constructed to estimate factors associated with eGFR decrease from baseline. A total of 329 patients were studied. Median follow-up was 2.7 years. Median eGFR decrease was -4.9 (-16.6 to +7.2) mL/min/1.73 m(2) . After multivariate stepwise regression analysis, age (P = 0.0002), non-African origin (P < 0.0001), baseline eGFR (P < 0.0001) and TDF duration (P = 0.02) were associated with eGFR decrease in the whole population, while hypertension, diabetes and type of infection were not. Age (P < 0.0001), non-African origin (P = 0.0004), baseline eGFR (P < 0.0001) and TDF duration (P = 0.007) remained associated with eGFR decline in HIV and HIV-HBV-infected patients, while other variables including HIV risk factor, CDC stage, CD4 and HIV-RNA levels were not. Age (P = 0.03), non-African origin (P = 0.004), baseline eGFR (P < 0.0001) and baseline HBV-DNA > 2000 IU/mL (P = 0.04) were associated with eGFR decline in HBV and HIV-HBV-infected patients, while other variables including HBV risk factor and fibrosis stage were not. Estimated glomerular filtration rate decline under TDF therapy appears mainly associated with older age, non-African origin, higher baseline eGFR and longer TDF administration but not with the type of viral infection. Regular follow-up of renal function, especially tubular function is recommended during TDF therapy.
authors.affiliation: Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Hépatologie, Lyon, France. pierre.pradat@univ-lyon1.fr
authors.forename: P
authors.initials: P
authors.lastname: Pradat
authors.forename: M-A
authors.initials: MA
authors.lastname: Le Pogam
authors.forename: J-B
authors.initials: JB
authors.lastname: Okon
authors.forename: P
authors.initials: P
authors.lastname: Trolliet
authors.forename: P
authors.initials: P
authors.lastname: Miailhes
authors.forename: C
authors.initials: C
authors.lastname: Brochier
authors.forename: M
authors.initials: M
authors.lastname: Maynard
authors.forename: F
authors.initials: F
authors.lastname: Bailly
authors.forename: F
authors.initials: F
authors.lastname: Zoulim
authors.forename: L
authors.initials: L
authors.lastname: Cotte
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D060085:Coinfection / Q000150:complications* / Q000473:pathology; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D012307:Risk Factors; D000068698:Tenofovir
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine
keywords: HBV; HIV; antiretroviral therapy; kidney disease; tenofovir