WHO antiretroviral therapy guidelines 2010 and impact of tenofovir on chronic kidney disease in Vietnamese HIV-infected patients.
OBJECTIVE
The 2010 WHO antiretroviral therapy (ART) guidelines have resulted in increased tenofovir use. Little is known about tenofovir-induced chronic kidney disease (CKD) in HIV-infected Vietnamese with mean body weight of 55 kg. We evaluated the prevalence and risk factors of CKD in this country.


METHODS
Cross-sectional study was performed.


METHODS
Clinical data on HIV-infected Vietnamese cohort were collected twice a year. To evaluate the prevalence of CKD, serum creatinine was measured in 771 patients in October 2011 and April 2012. CKD was defined as creatinine clearance less than 60 ml/min at both time points. Multivariate logistic regression was used to determine the factors associated with CKD.


RESULTS
Tenofovir use increased in Vietnam from 11.9% in April 2011 to 40.3% in April 2012. CKD was diagnosed in 7.3%, of which 7% was considered moderate and 0.3% was severe. Multivariate analysis of October-2011 data identified age per year-increase (OR: 1.229, 95%CI, 1.170-1.291), body weight per 1 kg-decrement (1.286, 1.193-1.386), and tenofovir use (2.715, 1.028-7.168) as risk factors for CKD.


CONCLUSIONS
Older age, low body weight and tenofovir use were independent risk factors for CKD in Vietnam. Further longitudinal study is required to evaluate the impact of TDF on renal function in Vietnam and other countries with small-body weight patients.
AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan ; Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
Daisuke
D
Mizushima
Junko
J
Tanuma
Fumihide
F
Kanaya
Takeshi
T
Nishijima
Hiroyuki
H
Gatanaga
Nguyen Tien
NT
Lam
Nguyen Thi Hoai
NT
Dung
Nguyen Van
NV
Kinh
Yoshimi
Y
Kikuchi
Shinichi
S
Oka
D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*; D000068698:Tenofovir; D014744:Vietnam
D019380:Anti-HIV Agents; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine