Abstract
Background The situation of renal impairment among HIV-infected patients treated with TDF-based antiretroviral (ARV) regimen greater than 3 years is little known when TDF use has been promptly increasing in Vietnam. Methods We analyse demographic and clinical data from a cross-sectional survey of 400 HIV-infected patients aged ≥18 years, who were treatment-naive or switched TDF regimen within over 3 years between November 2018 and March 2019. Serological tests for serum creatinine, ALT, and AST were performed. Renal impairment was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Multivariate regression analyses were used to explore the risk factors associated with renal impairment. Results At the baseline, 7.8% of respondents had estimated glomerular filtration rate (eGFR) of 30–59 mL/min/1.73 m2 and 0.8% had eGFR of 15–29 mL/min/1.73 m2, out of 34 (8.5%) of participants who had renal impairment. Multivariate analysis showed that participants who had preexposure to isoniazid (adjusted PR [aPR] = 0.35 Cl: 0.14–0.91) compared with nonexposure to isoniazid who had a BMI from 18.5 up to 25 kg/m2 (aPR = 0.31 Cl: 0.15–0.62) compared with BMI below 18.5 kg/m2 were less likely to suffer from renal impairment. Patients aged greater than 60 years (aPR = 26.75, 95% Cl: 3.38–211.62) compared with those aged 20–29 years were more likely to have increased risk of renal impairment. Conclusion Our findings underscore the need for longitudinal studies to assess the influence of TDF on maintaining the low prevalence of renal impairment among HIV-infected patients in Vietnam.
Highlights
From the first HIV case detected in 1990 to June 30, 2016, there were 227,225 reported cases of HIV infection in Vietnam, of which the number of patients turned to AIDS was 85,753, and 89,210 HIV/AIDS infected cases died [1]
Clinical Characteristics. e majority of study participants suffered from HIV through sexuality (89.5%); up to 98.3% of respondents were found in the World Health Organization (WHO) stage 1, and fifty percent recorded WHO stage 3 for starting treatment
We present findings from the renal impairment prevalence survey of semiurban HIV/AIDS patients conducted in southern Vietnam
Summary
From the first HIV case detected in 1990 to June 30, 2016, there were 227,225 reported cases of HIV infection in Vietnam, of which the number of patients turned to AIDS was 85,753, and 89,210 HIV/AIDS infected cases died [1]. Since 2010, the World Health Organization (WHO) recommended tenofovir disoproxil fumarate (TDF) containing regimens for the treatment of HIV-infected patients; it was used widespread and had officially become the preferred regimen [2] in Vietnam, since 2011, under the Decision 4139/QD-BYT of the Ministry of Health on amending and supplementing the guidelines for HIV/AIDS diagnosis and treatment. TDF, Lamivudine, and Efavirenz (TDF + 3TC + EFV) are the preferred treatment regimens for HIV/AIDS patients starting antiretroviral therapy (ARV), and ARV regimens containing TDF are considered a top priority [3, 4]. According to Decision No 5418/QD-BYT dated December 1, 2017 [3] of the Ministry of Health, Vietnam on issuing guidance for HIV/ AIDs treatment and care, TAF has not yet been used for regular treatment in the health care centers in Vietnam. Among adult HIV/AIDs patients, TDF is still quite popular in Vietnam
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