title: Renal Function Recovery and HIV Viral Suppression Following Tenofovir Discontinuation for Renal Impairment.
abstract: BACKGROUND
  Tenofovir associated nephrotoxicity (TDFN) is well recognized. This study describes the trend of renal function recovery and virologic consequences after cessation of tenofovir (TDF) for suspected TDFN.
  
  
  METHODS
  This was a retrospective chart review of 241 patients who underwent HLA-B*5701 allele testing between January 2007-December 2010. Demographics and clinical characteristics were compared at baseline, 3, 6, and 12 month between patients that continued and discontinued TDF. Factors associated with renal function recovery were assessed by multivariable logistic regression.
  
  
  RESULTS
  Eighty patients were identified with TDFN; 84% male, 74% African American (AA) with a median age of 55 years, and median length of TDF use for 122 weeks. Renal recovery at 12 months differed in those who stopped versus (vs.) continued TDF (83% vs. 57% p=0.03). In a crude analysis, baseline chronic kidney disease was negatively associated with renal recovery (p=0.01). An adjusted analysis showed that those who stopped TDF had 3.76 higher odds of renal recovery compared to those who did not stop TDF (95% CI: 1.26-11.27, p=0.02). There were no significant differences in virologic response after switching TDF to an alternative agent.
  
  
  CONCLUSIONS
  In this mostly AA male population with suspected TDFN, discontinuation of TDF was strongly associated with renal function recovery without affecting viral suppression.
authors.affiliation: The Miriam Hospital, Providence, RI, USA.
authors.forename: Francine Touzard
authors.initials: FT
authors.lastname: Romo
authors.affiliation: Rush University Medical Center, Chicago, IL, USA ; Cook County Health and Hospitals System, Chicago, IL, USA.
authors.forename: Mariam
authors.initials: M
authors.lastname: Aziz
authors.affiliation: Cook County Health and Hospitals System, Chicago, IL, USA.
authors.forename: Britt
authors.initials: B
authors.lastname: Livak
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Huesgen
authors.affiliation: Resurrection Health Care, Chicago, IL, USA.
authors.forename: Ben
authors.initials: B
authors.lastname: Colton
authors.affiliation: The Miriam Hospital, Providence, RI, USA ; Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Flanigan
authors.affiliation: Ruth M. Rothstein CORE Center, Chicago, IL, USA.
authors.forename: Blake
authors.initials: B
authors.lastname: Max
authors.affiliation: Rush University Medical Center, Chicago, IL, USA ; Cook County Health and Hospitals System, Chicago, IL, USA.
authors.forename: Harold
authors.initials: H
authors.lastname: Kessler
keywords: Nephrotoxicity; Renal failure; Tenofovir