title: Renal safety of coformulated tenofovir/emtricitabine vs other nucleoside analogues in combination therapy in antiretroviral-naive patients aged 50 years or older in Spain: The TRIP study.
abstract: Our aim is to describe the impact of emtricitabine (FTC)/tenofovir (TDF) versus other nucleoside reverse transcriptase inhibitor (NRTIs)-based regimens on renal function of human immunodeficiency virus (HIV) naïve patients >50 years old who started combination antiretroviral therapy (cART).
  
  
  
  National, retrospective cohort analysis of patients >50 years old when they started cART (January 1, 2006-December 31, 2009).
  
  
  
  We compared renal safety (changes in estimated glomerular filtration rate [eGFR] during the first year, and time to renal events during 4 years of follow-up) in FTC/TDF versus non-FTC/TDF users. Among FTC/TDF users, we compared protease inhibitors vs non-nucleoside reverse transcriptase inhibitors and Lopinavir/ritonavir vs Efavirenz.
  
  
  
  We included 103 patients: median age: 54.9 years, 84% males, median CD4 count 247 cells/μl, median viral load 4.7 log; median follow up 18 months (max: 48 months); 73 started with FTC/TDF and 30 with other NRTIs. Change in eGFR was significantly worse for ritonavir-boosted lopinavir (LPV/r) vs efavirenz (EFV) users in the FTC/TDF group (71.2 vs 98.9 ml/min/1.73 m(2) at month 12, P < 0.05). The risk of renal events (progression to an Chronic Kidney Disease Epidemiology Collaboration value < 60 ml/min/1.73 m(2) in subjects with baseline values >60) was comparable for FTC/TDF users and non users, but was higher and almost significant for LPV/r as compared to EFV users in the FTC/TDF group (adjusted hazard ratio 6.1, 95% CI 0.8-45.5).
  
  
  
  In our study with a population of HIV infected subjects ≥ 50 years old, renal safety was similar for FTC/TDF and other NRTI-based regimens, but worse for LPV/r as compared to other regimens.
authors.forename: Enric
authors.initials: E
authors.lastname: Pedrol
authors.forename: Ana M
authors.initials: AM
authors.lastname: Caro-Murillo
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Castaño
authors.forename: Melchor
authors.initials: M
authors.lastname: Riera
authors.forename: Julián
authors.initials: J
authors.lastname: Olalla
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Piedad
authors.initials: P
authors.lastname: Arazo
authors.forename: Juan L
authors.initials: JL
authors.lastname: Gómez-Sirvent
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
authors.forename: Alberto
authors.initials: A
authors.lastname: Romero-Palacios
authors.forename: Koldo
authors.initials: K
authors.lastname: Aguirrebengoa
authors.forename: Francisco
authors.initials: F
authors.lastname: Vera
authors.forename: Pedro
authors.initials: P
authors.lastname: Ferrer
authors.forename: José R
authors.initials: JR
authors.lastname: Blanco Ramos
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D004359:Drug Therapy, Combination; D000068679:Emtricitabine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D013030:Spain / Q000453:epidemiology; D000068698:Tenofovir / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D000068679:Emtricitabine
keywords: Ageing,; Antiretroviral Therapy; Emtricitabine,; Renal function,; Tenofovir,