Renal safety of coformulated tenofovir/emtricitabine vs other nucleoside analogues in combination therapy in antiretroviral-naive patients aged 50 years or older in Spain: The TRIP study

Our aim is to describe the impact of emtricitabine (FTC)/tenofovir (TDF) versus other nucleoside reverse transcriptase inhibitor (NRTIs)-based regimens on renal function of human immunodeficiency virus (HIV) naïve patients >50 years old who started combination antiretroviral therapy (cART). Natio...

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Bibliographic Details
Published in:	HIV clinical trials Vol. 16; no. 1; p. 43
Main Authors:	Pedrol, Enric, Caro-Murillo, Ana M, Castaño, Manuel A, Riera, Melchor, Olalla, Julián, Domingo, Pere, Arazo, Piedad, Gómez-Sirvent, Juan L, Pulido, Federico, Romero-Palacios, Alberto, Aguirrebengoa, Koldo, Vera, Francisco, Ferrer, Pedro, Blanco Ramos, José R
Format:	Journal Article
Language:	English
Published:	England 01-02-2015
Subjects:	Anti-HIV Agents - therapeutic use CD4 Lymphocyte Count Drug Therapy, Combination Emtricitabine - therapeutic use Female Follow-Up Studies HIV Infections - drug therapy HIV Infections - epidemiology Humans Male Middle Aged Retrospective Studies Reverse Transcriptase Inhibitors - therapeutic use Spain - epidemiology Tenofovir - therapeutic use Treatment Outcome Viral Load - drug effects Emtricitabine Tenofovir Renal function Antiretroviral Therapy Ageing
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Summary:	Our aim is to describe the impact of emtricitabine (FTC)/tenofovir (TDF) versus other nucleoside reverse transcriptase inhibitor (NRTIs)-based regimens on renal function of human immunodeficiency virus (HIV) naïve patients >50 years old who started combination antiretroviral therapy (cART). National, retrospective cohort analysis of patients >50 years old when they started cART (January 1, 2006-December 31, 2009). We compared renal safety (changes in estimated glomerular filtration rate [eGFR] during the first year, and time to renal events during 4 years of follow-up) in FTC/TDF versus non-FTC/TDF users. Among FTC/TDF users, we compared protease inhibitors vs non-nucleoside reverse transcriptase inhibitors and Lopinavir/ritonavir vs Efavirenz. We included 103 patients: median age: 54.9 years, 84% males, median CD4 count 247 cells/μl, median viral load 4.7 log; median follow up 18 months (max: 48 months); 73 started with FTC/TDF and 30 with other NRTIs. Change in eGFR was significantly worse for ritonavir-boosted lopinavir (LPV/r) vs efavirenz (EFV) users in the FTC/TDF group (71.2 vs 98.9 ml/min/1.73 m(2) at month 12, P < 0.05). The risk of renal events (progression to an Chronic Kidney Disease Epidemiology Collaboration value < 60 ml/min/1.73 m(2) in subjects with baseline values >60) was comparable for FTC/TDF users and non users, but was higher and almost significant for LPV/r as compared to EFV users in the FTC/TDF group (adjusted hazard ratio 6.1, 95% CI 0.8-45.5). In our study with a population of HIV infected subjects ≥ 50 years old, renal safety was similar for FTC/TDF and other NRTI-based regimens, but worse for LPV/r as compared to other regimens.
ISSN:	1528-4336
DOI:	10.1179/1528433614Z.0000000001