In:
JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 85, No. 2 ( 2020-10-1), p. 227-232
Abstract:
Whereas tenofovir disoproxil fumarate (TDF) can lead to renal adverse events, tenofovir alafenamide (TAF) has a more favorable renal safety profile. However, the impact of replacing TDF with TAF on renal function and liver parameters among HIV/hepatitis B virus (HBV)-coinfected individuals with renal dysfunction remains unclear. Methods: We included all participants from the Swiss HIV Cohort Study with an HIV/HBV coinfection who switched from TDF to TAF and had an estimated glomerular filtration rate (eGFR) 〈 90 mL/min/1.73 m 2 and a suppressed HIV viral load ( 〈 200 cp/mL). We assessed changes in eGFR, urine protein-to-creatinine ratio, and alanine aminotransferase (ALT) after 1 year using mixed-effect models with interrupted time series. Results: Among 106 participants (15.1% women, median age 53 years), eGFR was 60–89 mL/min/1.73 m 2 in 84 (79.2%) and 〈 60 mL/min/1.73 m 2 in 22 (20.8%) individuals at the time of switch. One year after the switch from TDF to TAF, individuals with an eGFR between 60 and 89 mL/min/1.73 m 2 experienced increases in eGFR of 3.2 mL/min/1.73 m 2 (95% confidence interval [CI] 1.2 to 5.2), whereas those with an eGFR 〈 60 mL/min/1.73 m 2 experienced improvements of 6.2 mL/min/1.73 m 2 (95% CI 2.4 to 10.0). Urine protein-to-creatinine ratio decreased overall (−6.3 mg/mmol, 95% CI −10.0 to −2.7), and ALT levels declined in patients with elevated baseline levels (−11.8 IU/L, 95% CI −17.3 to −6.4) 1 year after replacing TDF with TAF. Conclusions: Switching from TDF to TAF among HIV/HBV-coinfected individuals with renal impairment led to improvements in eGFR, a decline in proteinuria, and to ALT normalization in those with elevated ALT levels.
Type of Medium:
Online Resource
ISSN:
1525-4135
DOI:
10.1097/QAI.0000000000002429
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2038673-4
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