TENOFOVIR ASSOCIATED RENAL TOXICITY IN A COHORT OF HIV INFECTED INDIVIDUALS IN GOA

Dr. Hardik P Patel; Dr. Shubham Kumar; Dr. Deepashree Talaulikar

Volume : X, Issue : I, January - 2020

TENOFOVIR ASSOCIATED RENAL TOXICITY IN A COHORT OF HIV INFECTED INDIVIDUALS IN GOA

Dr. Hardik P Patel, Dr. Shubham Kumar, Dr. Deepashree Talaulikar

Abstract :

Objective: Tenofovir disoproxil fumarate (TDF) is a nucleotide analogue recommended in international HIV treatment guidelines. Purpose of this study was to estimate the long term effects of TDF on renal profile in a cohort of HIV patients in Goa. Three hundred and fifty four (354) consecutive HIV–positive patients who initiated TDF–based antiretroviral treatment from Jan 2016 to Dec 2018 at the Goa Medical College were sampled. Creatinine clearance (CrCl) was calculated using the Cockcroft–Gault equation at baseline and renal impairment was defined as CrCl values of 30.0–49.9 mL/min (moderate renal impairment) and < 25 mL/min (severe renal impairment) as per institutional guidelines for renal function test. Results: Follow up time was 2 years. At study endpoint, 36 participants (10.2%) recorded CrCl rate below 50 mL/min indicating incident renal impairment, made up of 8.47% moderate renal impairment and 1.7% severe renal impairment. Factors associated with incidence of renal impairment were increasing age, WHO HIV stage III/IV and baseline low CD4 count. Patients with identified renal impairment risk factors at ART initiation should be targeted and monitored effectively to prevent renal injury.