Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia

Kedar Joshi, David Boettiger, Stephen Kerr, Takeshi Nishijima, Kinh Van Nguyen, Penh Sun Ly, Man Po Lee, Nagalingeswaran Kumarasamy, Wingwai Wong, Pacharee Kantipong, Do Duy Cuong, Adeeba Kamarulzaman, Jun Yong Choi, Fujie Zhang, Romanee Chaiwarith, Oon Tek Ng, Sasisopin Kiertiburanakul, Benedict Lim Heng Sim, Tuti Parwati Merati, Evy YunihastutiRossana Ditangco, Jeremy Ross, Sanjay Pujari

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Renal disease is common among people living with human immunodeficiency virus (HIV). However, there is limited information on the incidence and risk factors associated with renal dysfunction among this population in Asia. Methods: We used data from the TREAT Asia HIV Observational Database. Patients were included if they started antiretroviral therapy during or after 2003, had a serum creatinine measurement at antiretroviral therapy initiation (baseline), and had at least 2 follow-up creatinine measurements taken ≥3 months apart. Patients with a baseline estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m2 were excluded. Chronic kidney disease was defined as 2 consecutive eGFR values ≤60 mL/min/1.73 m2 taken ≥3 months apart. Generalized estimating equations were used to identify factors associated with eGFR change. Competing risk regression adjusted for study site, age and sex, and cumulative incidence plots were used to evaluate factors associated with chronic kidney disease (CKD). Results: Of 2547 patients eligible for this analysis, tenofovir was being used by 703 (27.6%) at baseline. Tenofovir use, high baseline eGFR, advanced HIV disease stage, and low nadir CD4 were associated with a decrease in eGFR during follow-up. Chronic kidney disease occurred at a rate of 3.4 per 1000 patient/years. Factors associated with CKD were tenofovir use, old age, low baseline eGFR, low nadir CD4, and protease inhibitor use. Conclusions: There is an urgent need to enhance renal monitoring and management capacity among at-risk groups in Asia and improve access to less nephrotoxic antiretrovirals.

Original languageEnglish
Pages (from-to)1209-1216
Number of pages8
JournalPharmacoepidemiology and Drug Safety
Volume27
Issue number11
DOIs
Publication statusPublished - 2018 Nov

Fingerprint

Tenofovir
Glomerular Filtration Rate
HIV
Chronic Renal Insufficiency
Kidney
Creatinine
Therapeutics
Incidence
Virus Diseases
Protease Inhibitors
Databases
Serum
Population

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Pharmacology (medical)

Cite this

Joshi, K., Boettiger, D., Kerr, S., Nishijima, T., Van Nguyen, K., Ly, P. S., ... Pujari, S. (2018). Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia. Pharmacoepidemiology and Drug Safety, 27(11), 1209-1216. https://doi.org/10.1002/pds.4657
Joshi, Kedar ; Boettiger, David ; Kerr, Stephen ; Nishijima, Takeshi ; Van Nguyen, Kinh ; Ly, Penh Sun ; Lee, Man Po ; Kumarasamy, Nagalingeswaran ; Wong, Wingwai ; Kantipong, Pacharee ; Cuong, Do Duy ; Kamarulzaman, Adeeba ; Choi, Jun Yong ; Zhang, Fujie ; Chaiwarith, Romanee ; Ng, Oon Tek ; Kiertiburanakul, Sasisopin ; Sim, Benedict Lim Heng ; Merati, Tuti Parwati ; Yunihastuti, Evy ; Ditangco, Rossana ; Ross, Jeremy ; Pujari, Sanjay. / Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia. In: Pharmacoepidemiology and Drug Safety. 2018 ; Vol. 27, No. 11. pp. 1209-1216.
@article{1790b8675d98452caaead0474faf9bea,
title = "Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia",
abstract = "Purpose: Renal disease is common among people living with human immunodeficiency virus (HIV). However, there is limited information on the incidence and risk factors associated with renal dysfunction among this population in Asia. Methods: We used data from the TREAT Asia HIV Observational Database. Patients were included if they started antiretroviral therapy during or after 2003, had a serum creatinine measurement at antiretroviral therapy initiation (baseline), and had at least 2 follow-up creatinine measurements taken ≥3 months apart. Patients with a baseline estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m2 were excluded. Chronic kidney disease was defined as 2 consecutive eGFR values ≤60 mL/min/1.73 m2 taken ≥3 months apart. Generalized estimating equations were used to identify factors associated with eGFR change. Competing risk regression adjusted for study site, age and sex, and cumulative incidence plots were used to evaluate factors associated with chronic kidney disease (CKD). Results: Of 2547 patients eligible for this analysis, tenofovir was being used by 703 (27.6{\%}) at baseline. Tenofovir use, high baseline eGFR, advanced HIV disease stage, and low nadir CD4 were associated with a decrease in eGFR during follow-up. Chronic kidney disease occurred at a rate of 3.4 per 1000 patient/years. Factors associated with CKD were tenofovir use, old age, low baseline eGFR, low nadir CD4, and protease inhibitor use. Conclusions: There is an urgent need to enhance renal monitoring and management capacity among at-risk groups in Asia and improve access to less nephrotoxic antiretrovirals.",
author = "Kedar Joshi and David Boettiger and Stephen Kerr and Takeshi Nishijima and {Van Nguyen}, Kinh and Ly, {Penh Sun} and Lee, {Man Po} and Nagalingeswaran Kumarasamy and Wingwai Wong and Pacharee Kantipong and Cuong, {Do Duy} and Adeeba Kamarulzaman and Choi, {Jun Yong} and Fujie Zhang and Romanee Chaiwarith and Ng, {Oon Tek} and Sasisopin Kiertiburanakul and Sim, {Benedict Lim Heng} and Merati, {Tuti Parwati} and Evy Yunihastuti and Rossana Ditangco and Jeremy Ross and Sanjay Pujari",
year = "2018",
month = "11",
doi = "10.1002/pds.4657",
language = "English",
volume = "27",
pages = "1209--1216",
journal = "Pharmacoepidemiology and Drug Safety",
issn = "1053-8569",
publisher = "John Wiley and Sons Ltd",
number = "11",

}

Joshi, K, Boettiger, D, Kerr, S, Nishijima, T, Van Nguyen, K, Ly, PS, Lee, MP, Kumarasamy, N, Wong, W, Kantipong, P, Cuong, DD, Kamarulzaman, A, Choi, JY, Zhang, F, Chaiwarith, R, Ng, OT, Kiertiburanakul, S, Sim, BLH, Merati, TP, Yunihastuti, E, Ditangco, R, Ross, J & Pujari, S 2018, 'Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia', Pharmacoepidemiology and Drug Safety, vol. 27, no. 11, pp. 1209-1216. https://doi.org/10.1002/pds.4657

Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia. / Joshi, Kedar; Boettiger, David; Kerr, Stephen; Nishijima, Takeshi; Van Nguyen, Kinh; Ly, Penh Sun; Lee, Man Po; Kumarasamy, Nagalingeswaran; Wong, Wingwai; Kantipong, Pacharee; Cuong, Do Duy; Kamarulzaman, Adeeba; Choi, Jun Yong; Zhang, Fujie; Chaiwarith, Romanee; Ng, Oon Tek; Kiertiburanakul, Sasisopin; Sim, Benedict Lim Heng; Merati, Tuti Parwati; Yunihastuti, Evy; Ditangco, Rossana; Ross, Jeremy; Pujari, Sanjay.

In: Pharmacoepidemiology and Drug Safety, Vol. 27, No. 11, 11.2018, p. 1209-1216.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Changes in renal function with long-term exposure to antiretroviral therapy in HIV-infected adults in Asia

AU - Joshi, Kedar

AU - Boettiger, David

AU - Kerr, Stephen

AU - Nishijima, Takeshi

AU - Van Nguyen, Kinh

AU - Ly, Penh Sun

AU - Lee, Man Po

AU - Kumarasamy, Nagalingeswaran

AU - Wong, Wingwai

AU - Kantipong, Pacharee

AU - Cuong, Do Duy

AU - Kamarulzaman, Adeeba

AU - Choi, Jun Yong

AU - Zhang, Fujie

AU - Chaiwarith, Romanee

AU - Ng, Oon Tek

AU - Kiertiburanakul, Sasisopin

AU - Sim, Benedict Lim Heng

AU - Merati, Tuti Parwati

AU - Yunihastuti, Evy

AU - Ditangco, Rossana

AU - Ross, Jeremy

AU - Pujari, Sanjay

PY - 2018/11

Y1 - 2018/11

N2 - Purpose: Renal disease is common among people living with human immunodeficiency virus (HIV). However, there is limited information on the incidence and risk factors associated with renal dysfunction among this population in Asia. Methods: We used data from the TREAT Asia HIV Observational Database. Patients were included if they started antiretroviral therapy during or after 2003, had a serum creatinine measurement at antiretroviral therapy initiation (baseline), and had at least 2 follow-up creatinine measurements taken ≥3 months apart. Patients with a baseline estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m2 were excluded. Chronic kidney disease was defined as 2 consecutive eGFR values ≤60 mL/min/1.73 m2 taken ≥3 months apart. Generalized estimating equations were used to identify factors associated with eGFR change. Competing risk regression adjusted for study site, age and sex, and cumulative incidence plots were used to evaluate factors associated with chronic kidney disease (CKD). Results: Of 2547 patients eligible for this analysis, tenofovir was being used by 703 (27.6%) at baseline. Tenofovir use, high baseline eGFR, advanced HIV disease stage, and low nadir CD4 were associated with a decrease in eGFR during follow-up. Chronic kidney disease occurred at a rate of 3.4 per 1000 patient/years. Factors associated with CKD were tenofovir use, old age, low baseline eGFR, low nadir CD4, and protease inhibitor use. Conclusions: There is an urgent need to enhance renal monitoring and management capacity among at-risk groups in Asia and improve access to less nephrotoxic antiretrovirals.

AB - Purpose: Renal disease is common among people living with human immunodeficiency virus (HIV). However, there is limited information on the incidence and risk factors associated with renal dysfunction among this population in Asia. Methods: We used data from the TREAT Asia HIV Observational Database. Patients were included if they started antiretroviral therapy during or after 2003, had a serum creatinine measurement at antiretroviral therapy initiation (baseline), and had at least 2 follow-up creatinine measurements taken ≥3 months apart. Patients with a baseline estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m2 were excluded. Chronic kidney disease was defined as 2 consecutive eGFR values ≤60 mL/min/1.73 m2 taken ≥3 months apart. Generalized estimating equations were used to identify factors associated with eGFR change. Competing risk regression adjusted for study site, age and sex, and cumulative incidence plots were used to evaluate factors associated with chronic kidney disease (CKD). Results: Of 2547 patients eligible for this analysis, tenofovir was being used by 703 (27.6%) at baseline. Tenofovir use, high baseline eGFR, advanced HIV disease stage, and low nadir CD4 were associated with a decrease in eGFR during follow-up. Chronic kidney disease occurred at a rate of 3.4 per 1000 patient/years. Factors associated with CKD were tenofovir use, old age, low baseline eGFR, low nadir CD4, and protease inhibitor use. Conclusions: There is an urgent need to enhance renal monitoring and management capacity among at-risk groups in Asia and improve access to less nephrotoxic antiretrovirals.

UR - http://www.scopus.com/inward/record.url?scp=85053721521&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053721521&partnerID=8YFLogxK

U2 - 10.1002/pds.4657

DO - 10.1002/pds.4657

M3 - Article

C2 - 30246898

AN - SCOPUS:85053721521

VL - 27

SP - 1209

EP - 1216

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

SN - 1053-8569

IS - 11

ER -