- 作者：Miriam Esté ; banez ; miriam.estebanez@salud.madrid.org" class="auth_mail" title="E-mail the corresponding author ; Jose I. Bernardino ; Lucí ; a Serrano ; Ignacio Pé ; rez-Valero ; Francisco X. Zamora ; Maria L. Montes-Ramí ; rez ; Juan J. Gonzá ; lez-Garcí ; a ; Jose R. Arribas
- 关键词：Reversibility ; Renal toxicity ; Tenofovir ; Monotherapy ; HIV
- 刊名：Enfermedades Infecciosas y Microbiología Clínica
- 出版年：2016
- 出版时间：January 2016
- 年：2016
- 卷：34
- 期：1
- 页码：29-32
- 全文大小：318 K
Methods
All patients who had received a TDF-containing regimen for at least one year and had been switched to PI monotherapy were included. A rapid decrease in CG-CrCl during exposure to TDF was defined as a decrease in CG-CrCl at least five times higher than the expected due to age (0.4 ml/min/year by the years of exposure to TDF). In this subgroup of patients, we considered improvement if the last value of CG-CrCl on PI monotherapy was 10% higher than the last value of CG-CrCl before switching to PI monotherapy. A multivariate logistic regression was constructed to identify factors associated to renal improvement after switching to bPI monotherapy.
Results
64 patients included. The median (IQR) annual change in CG-CrCl during PI monotherapy was significantly lower than the median (IQR) annual change while exposed to TDF [−0.9 (−4.7 to +2.8) ml/min vs. −4 (−8 to −1) ml/min, p = 0.001]. 44 patients experienced a rapid decline during TDF exposition. After switch to PI monotherapy, 15/44 (34%, 95% CI: 21–50%) had an improved CG-CrCl and 16/44 (36%, CI 23–52%) experienced a further decline in CG-CrCl. The only variable associated to CG-CrCl improvement was a more rapid CG-CrCl decline in the last year of exposure to TDF.
Conclusion
Switching to PI monotherapy partially reversed CG-CrCl decrease associated to TDF use, especially in patients with a more rapid decline while receiving TDF.