原创力文档renal safety of tenofovir containing antiretroviral regimen in a singapore cohort肾安全含有抗逆转录病毒疗法的替诺福韦在新加坡队列.pdfVIP
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renal safety of tenofovir containing antiretroviral regimen in a singapore cohort肾安全含有抗逆转录病毒疗法的替诺福韦在新加坡队列
Chua et al. AIDS Research and Therapy 2012, 9:19
/content/9/1/19
SHORT REPORT Open Access
Renal safety of tenofovir containing antiretroviral
regimen in a Singapore cohort
1* 1 2 3 2
Arlene C Chua , Ryan M Llorin , Kelvin Lai , Philippe Cavailler and Hwa Lin Law
Abstract
Background: Tenofovirdisoproxilfumarate (TDF) is a nucleotide analogue widely recommended in international HIV
treatment guidelines. The association of TDF and renal dysfunction has remained an area of interest.
Findings: We conducted a retrospective review of all patients on TDF from July 2007 to December 2009 in our
institution and evaluated their renal function. Absolute change of creatinine clearance (CLCr) using Cockroft-Gault
equation from baseline was calculated at 6, 12, 18 and 24 months. Overall, 226 patients were included in the study.
Ninety percent were male. The median age was 46 yrs old (23–82), median weight was 60 kg (IQR 53.75-68),
median CD4 count was 127 cells/mm3 (IQR 38–258) and median CLCr 82.7 mL/min (IQR 71.4-101.7) on initiation of
TDF. The median decline of CLCr from baseline was −3.9 ml/min (IQR −12.3 to 7.6), and −3.6 ml/min (IQR −12.4 to
6.7) at 12 (n = 102), 24 months (n = 75) respectively. Eighteen of 226 patients had a decline in renal function to
/=50 ml/min. Majority of which had an improvement of CLCr on follow up. Only 80% of patients ever received
monitoring of renal function.
Conclusion: While we noted renal toxicity to be rare and transient among our cohort receiving TDF as part of their
ARV regimen, these results reflect the short term renal effects of TDF given that ARV treatment is lifelong. Given
that laboratory monitoring may be difficult to implement in many situations, future prospective stu
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