Changes in renal function after switching from TDF to TAF in HIV-infected individuals: a prospective cohort study.

Surial, Bernard; Ledergerber, Bruno; Calmy, Alexandra; Cavassini, Matthias; Günthard, Huldrych F; Kovari, Helen; Stöckle, Marcel; Bernasconi, Enos; Schmid, Patrick; Fux, Christoph A; Furrer, Hansjakob; Rauch, Andri; Wandeler, Gilles (2020). Changes in renal function after switching from TDF to TAF in HIV-infected individuals: a prospective cohort study. Journal of infectious diseases, 222(4), pp. 637-645. Oxford University Press 10.1093/infdis/jiaa125

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BACKGROUND

Replacing tenofovir disoproxil fumarate (TDF) with tenofovir alafenamide (TAF) improves renal tubular markers in HIV-infected individuals, but the impact on estimated glomerular filtration rate (eGFR) remains unclear.

METHODS

We included all participants from the Swiss HIV Cohort Study who switched from a TDF to a TAF-containing antiretroviral regimen or continued TDF. We estimated changes in eGFR and urine protein-to-creatinine ratio (UPCR) after 18 months using mixed-effect models.

RESULTS

Of 3'520 participants (26.6% women, median age 50 years), 2'404 (68.5%) switched to TAF. Prior to switch, 1'664 (47.3%) had an eGFR <90 mL/min, and 1'087 (30.9%) a UPCR ≥15 mg/mmol. In patients with a baseline eGFR ≥90 mL/min, eGFR decreased with the use of TDF and TAF (-1.7 ml/min). Switching to TAF was associated with increases in eGFR of 1.5 mL/min (95% CI 0.5-2.5) if the baseline eGFR was 60-89 mL/min, and 4.1 mL/min (95% CI 1.6-6.6) if <60 mL/min. In contrast, eGFR decreased by 5.8 mL/min (95% CI 2.3-9.3) with the continued use of TDF in individuals with a baseline eGFR <60 mL/min. UPCR decreased after replacing TDF by TAF, independent of baseline eGFR.

CONCLUSIONS

Switching from TDF to TAF improves eGFR and proteinuria in patients with renal dysfunction.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Surial, Bernard; Furrer, Hansjakob; Rauch, Andri and Wandeler, Gilles

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

0022-1899

Publisher:

Oxford University Press

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

07 Apr 2020 16:24

Last Modified:

13 Aug 2020 12:29

Publisher DOI:

10.1093/infdis/jiaa125

PubMed ID:

32189003

Uncontrolled Keywords:

Tenofovir alafenamide antiretroviral therapy comorbidities estimated glomerular filtration rate renal tubulopathy switch urine protein-to-creatinine ratio

BORIS DOI:

10.7892/boris.142237

URI:

https://boris.unibe.ch/id/eprint/142237

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