A study of renal dysfunction among HIV-infected patients on tenofovir based ART regimen in the Northeast part of India

Abstract

Background: Tenofovir is an integral part of the currently used antiretroviral therapy (ART) regime. However, nephrotoxicity has been a concern. This study has been undertaken to evaluate the prevalence and risk factors of renal dysfunction among HIV-patients on tenofovir containing ART regime.Methods: This cohort study was conducted at Regional Institute of Medical Sciences. HIV-patients newly started on tenofovir containing ART regime were subjected to detailed history, thorough physical examination, and routine investigations. Serum creatinine levels and creatinine clearance were measured at regular intervals.Results: Mean age of the patients was 42.37±10.8 years. Most of the patients had normal BMI (66%) and 22% were obese while 12% of the cases were underweight. Majority of the patients had CD4 count less than 350 cells/cumm. Renal dysfunction, defined as creatinine clearance <50 ml/min, developed in 9% of the patients at 3 months and in 33% of the patients at 6 months. Old age, low CD4 cell count, HCV co-infection, and advanced HIV infection were found to be important risk factors.Conclusions: Development of renal dysfunction is common among HIV patients receiving tenofovir-based ART regimen. Old age, low CD4 cell count, HCV co-infection, and advanced HIV infection were found to be important risk factors.