title: Impact of tenofovir dose adjustment on both estimated glomerular filtration rate and tenofovir trough concentration.
abstract: BACKGROUND
  Tenofovir disoproxil fumarate (TDF)-based regimen is a treatment option for HIV-infected patients. TDF dose adjustment is recommended in patients with impaired renal function. We assessed the impact of TDF dose adjustment on renal function and tenofovir trough concentration.
  
  
  METHODS
  Fourteen HIV patients for whom TDF dose was adjusted (1 tablet/48 h) because of estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, and/or due to a tenofovir trough concentration >90 ng/ml between 2006 and 2013 were selected. The eGFR was measured at baseline and 3, 6 and 12 months after TDF dose adjustment.
  
  
  RESULTS
  A 50% TDF dose reduction resulted in a significant increase of the eGFR 3 months after dose adjustment (61.1 versus 72.8 ml/min/1.73 m2; P=0.003). Concomitantly, tenofovir trough concentration decreased from 175 to 66 ng/ml (P=0.009). Antiviral efficacy was maintained in all patients.
  
  
  CONCLUSIONS
  TDF dose adjustment combined with therapeutic drug monitoring may be useful especially in patients at risk of kidney dysfunction.
authors.affiliation: Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bregigeon
authors.affiliation: Aix-Marseille University, APHM La Timone, Pharmacocinétique et Toxicologie, INSERM S_911 CRO2-SMARTc, Marseille, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Solas
authors.affiliation: Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Faucher
authors.affiliation: Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Obry-Roguet
authors.affiliation: IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, APHM Timone, Marseille, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tamalet
authors.affiliation: Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France.|INSERM U912 (SESSTIM), Marseille, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000068698:Tenofovir / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D019380:Anti-HIV Agents; D000068698:Tenofovir