Abstract
ObjectiveThe 2010 WHO antiretroviral therapy (ART) guidelines have resulted in increased tenofovir use. Little is known about tenofovir-induced chronic kidney disease (CKD) in HIV-infected Vietnamese with mean body weight of 55 kg. We evaluated the prevalence and risk factors of CKD in this country.DesignCross-sectional study was performed.MethodsClinical data on HIV-infected Vietnamese cohort were collected twice a year. To evaluate the prevalence of CKD, serum creatinine was measured in 771 patients in October 2011 and April 2012. CKD was defined as creatinine clearance less than 60 ml/min at both time points. Multivariate logistic regression was used to determine the factors associated with CKDResultsTenofovir use increased in Vietnam from 11.9% in April 2011 to 40.3% in April 2012. CKD was diagnosed in 7.3%, of which 7% was considered moderate and 0.3% was severe. Multivariate analysis of October-2011 data identified age per year-increase (OR: 1.229, 95%CI, 1.170-1.291), body weight per 1 kg-decrement (1.286, 1.193-1.386), and tenofovir use (2.715, 1.028-7.168) as risk factors for CKD.ConclusionsOlder age, low body weight and tenofovir use were independent risk factors for CKD in Vietnam. Further longitudinal study is required to evaluate the impact of TDF on renal function in Vietnam and other countries with small-body weight patients.
Highlights
Advances in antiretroviral therapy (ART) had turned HIV/ AIDS into a chronic disease [1,2,3,4,5]
In addition to the established risk factors, such as aging, diabetes mellitus (DM) and hypertension [2,10], other factors related to the virus itself and to the treatment [e.g., exposure to tenofovir (TDF), a commonly used antiretroviral (ARV)], are thought to be related to nephrotoxicity in HIV-infected patients[2,11,12]
chronic kidney disease (CKD) was defined as creatinine clearance (Ccl) estimated by the Cockcroft-Gault formula of
Summary
Advances in antiretroviral therapy (ART) had turned HIV/ AIDS into a chronic disease [1,2,3,4,5]. As a consequence of living longer, chronic kidney disease (CKD) has become an important cause of morbidity and mortality in HIV-infected patients [1,3,4,5]. In addition to the established risk factors, such as aging, diabetes mellitus (DM) and hypertension [2,10], other factors related to the virus itself and to the treatment [e.g., exposure to tenofovir (TDF), a commonly used antiretroviral (ARV)], are thought to be related to nephrotoxicity in HIV-infected patients[2,11,12]. The 2010 WHO guidelines for ART in adults and adolescents recommended TDF as part of the first line regimens (URL: http:// whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf)
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