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- Title
Changes in Renal Function After Switching From TDF to TAF in HIV-Infected Individuals: A Prospective Cohort Study.
- Authors
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; Study, Swiss HIV Cohort; Swiss HIV Cohort Study
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>In all participants from the Swiss HIV Cohort Study who switched from TDF to 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.<bold>Results: </bold>Of 3520 participants (26.6% women, median age 50 years), 2404 (68.5%) switched to TAF. Overall, 1664 (47.3%) had an eGFR <90 mL/min and 1087 (30.9%) an UPCR ≥15 mg/mmol. In patients with 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% confidence interval [CI], .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 continued use of TDF in individuals with baseline eGFR <60 mL/min. UPCR decreased after replacing TDF by TAF, independent of baseline eGFR.<bold>Conclusions: </bold>Switching from TDF to TAF improves eGFR and proteinuria in patients with renal dysfunction.
- Subjects
SWITZERLAND; HIV-positive persons; COHORT analysis; GLOMERULAR filtration rate; LONGITUDINAL method; ANTI-HIV agents; HIV infections; RESEARCH; KIDNEY function tests; PURINES; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; MEDICAL prescriptions
- Publication
Journal of Infectious Diseases, 2020, Vol 222, Issue 4, p637
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiaa125