Renal Safety of a Tenofovir-Containing First Line Regimen: Experience from an Antiretroviral Cohort in Rural Lesotho


Bygrave, H; Kranzer, K; Hilderbrand, K; Jouquet, G; Goemaere, E; Vlahakis, N; Trivino, L; Makakole, L; Ford, N; (2011) Renal Safety of a Tenofovir-Containing First Line Regimen: Experience from an Antiretroviral Cohort in Rural Lesotho. PLoS One, 6 (3). ISSN 1932-6203 DOI: https://doi.org/10.1371/journal.pone.0017609

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Abstract

Introduction: Current guidelines contraindicate TDF use when creatinine clearance (CrCl) falls below 50 ml/min. We report prevalence of abnormal renal function at baseline and factors associated with abnormal renal function from a community cohort in Lesotho. Methods: We calculated changes in CrCl from baseline for patients initiated on TDF at 6 and 12 months and the proportion of patients initiated on TDF who developed renal impairment. Screening algorithms were developed using risk factors determined by multivariate analysis. Results: Among 933 adults for whom baseline creatinine was available, 176 (18.9%) presented with a baseline CrCl < 50 ml/min. Renal function improved during follow-up. 19 patients who developed renal toxicity during follow up remained on TDF; renal function improved (CrCl >= 50 ml/min) in all but 3 of these patients. Among 15 patients with a baseline CrCl,50 ml/min were started in error, none developed severe renal impairment. Conclusion: In this setting TDF-associated renal toxicity is rare and mainly transient. Further studies to assess TDF safety at lower CrCl thresholds are warranted.

Item Type: Article
Keywords: DISOPROXIL FUMARATE, THERAPY, HIV, ZAMBIA, DF
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 21407815
Web of Science ID: 287933300034
URI: http://researchonline.lshtm.ac.uk/id/eprint/1166

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