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Renal Function in Tenofovir-Exposed and Tenofovir-Unexposed Patients Receiving Highly Active Antiretroviral Therapy in the HIV Outpatient Study

Rose Medical Center, Denver, Colorado, denveridc{at}aol.com

Kate Buchacz, PhD

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

Rose K. Baker, MS

Cerner Corporation, Vienna, Virginia

Anne C. Moorman, BSN, MPH

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

Kathy C. Wood, BSN

Cerner Corporation, Vienna, Virginia

Joan Chmiel, PhD

Feinberg School of Medicine, Northwestern University, Chicago, Illinois

John T. Brooks, MD

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

HIV Outpatient Study Investigators

Background: Cases of renal dysfunction have been reported in HIV-infected patients taking tenofovir (TDF), but few large studies have examined population-level changes in renal function associated with TDF use in patients in routine care. Methods: The authors analyzed data from participants in the HIV Outpatient Study (HOPS) who had normal baseline renal function and received >1 month of TDF-containing (n = 593) or TDF-sparing (n = 521) HAART after November 1, 2001. Results: Median baseline CrCl estimated by Cockcroft-Gault equation was 106 mL/min for TDF-exposed and 110 mL/min for TDF-unexposed patients (P = 0.06). In multivariable analyses, 1-year changes in CrCl (mL/min) from baseline were —5.7 among TDF-exposed and 2.6 among TDF-unexposed (P < 0.001). Incident renal disease was diagnosed in 7 TDF-exposed and 3 TDF-unexposed patients. Conclusions: In this large cohort of HIV-infected outpatients, use of TDF-containing HAART was associated with modest decreases in CrCl during the first year, but not with frequent, clinically significant renal toxicity.

Key Words: tenofovir • renal disease • toxicity • highly active antiretroviral therapy • creatinine clearance

This version was published on September 1, 2007

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 6, No. 3, 178-187 (2007)
DOI: 10.1177/1545109707300676


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