Renal health after long-term exposure to tenofovir disoproxil fumarate in HIV_HBV postive adults in Ghana.pdf (466.05 kB)
Renal health after long-term exposure to tenofovir disoproxil fumarate (TDF) in HIV/HBV positive adults in Ghana
journal contribution
posted on 2023-06-09, 20:04 authored by Giovanni Villa, R O Phillips, C Smith, A J Stockdale, A Beloukas, L T Appiah, D Chadwick, A Ruggiero, F S Sarfo, F Post, A M GerettiObjectives: The study assessed markers of renal health in HIV/HBV co-infected patients receiving TDF- containing antiretroviral therapy in Ghana. Methods: Urinary protein-to-creatinine ratio (uPCR) and albumin-to-protein ratio (uAPR) were measured cross-sectionally after a median of four years of TDF. At this time, alongside extensive laboratory testing, patients underwent evaluation of liver stiffness and blood pressure. The estimated glomerular filtration rate (eGFR) was measured longitudinally before and during TDF therapy. Results: Among 101 participants (66% women, median age 44 years, median CD4 count 572 cells/mm 3 ) 21% and 17% had detectable HIV-1 RNA and HBV DNA, respectively. Overall 35% showed hypertension, 6% diabetes, 7% liver stiffness indicative of cirrhosis, and 18% urinary excretion of Schistosoma antigen. Tubular proteinuria occurred in 16% of patients and was independently predicted by female gender and hypertension. The eGFR declined by median 1.8 ml/min/year during TDF exposure (IQR -4.4, -0.0); more pronounced declines ( =5 ml/min/year) occurred in 22% of patients and were associated with receiv-ing ritonavir-boosted lopinavir rather than efavirenz. HBV DNA, HBeAg, transaminases, and liver stiffness were not predictive of renal function abnormalities. Conclusions: The findings mandate improved diagnosis and management of hypertension and suggest targeted laboratory monitoring of patients receiving TDF alongside a booster in sub-Saharan Africa.
History
Publication status
- Published
File Version
- Published version
Journal
Journal of InfectionISSN
0163-4453Publisher
ElsevierExternal DOI
Issue
6Volume
76Page range
515-521Department affiliated with
- BSMS Publications
Research groups affiliated with
- Brighton and Sussex Centre for Global Health Research Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2020-01-03First Open Access (FOA) Date
2020-01-03First Compliant Deposit (FCD) Date
2020-01-02Usage metrics
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