Renal function in Japanese HIV-1-positive patients who switch to tenofovir alafenamide fumarate after long-term tenofovir disoproxil fumarate: a single-center observational study

AIDS Research and Therapy

Junji Imamura¹  Toshihiro Ito¹  Taku Obara²  Asahi Kondo³  Satomi Kamio³  Tatsuya Goto³  Nobuyuki Takahashi⁴  Kensuke Abe⁵  Hiroshi Sato⁶ 

[1] Department of Infectious Diseases, National Hospital Organization Sendai Medical Center, Sendai, Japan;Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan;Department of Pharmacy, National Hospital Organization Sendai Medical Center, 2-11-12 Miyagino, Miyagino-ku, 983-8520, Sendai, Miyagi, Japan;Division of Clinical Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan;Division of Clinical Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan;Department of Pharmacy, National Hospital Organization Sendai Medical Center, 2-11-12 Miyagino, Miyagino-ku, 983-8520, Sendai, Miyagi, Japan;JR Sendai Hospital, Sendai, Japan;

关键词: Tenofovir alafenamide fumarate;    Tenofovir disoproxil fumarate;    Renal function;    eGFR;    HIV;   

DOI  :  10.1186/s12981-021-00420-5

来源: Springer

【 摘 要 】

BackgroundTenofovir disoproxil fumarate (TDF) has a strong antiviral effect, but TDF is known to cause renal dysfunction. Therefore, we are investigating preventing renal dysfunction by replacing TDF with tenofovir alafenamide fumarate (TAF), which is known to be relatively safe to the kidneys. However, the changes in renal function under long-term use of TAF are not known. In this study, we evaluated renal function in Japanese HIV-1-positive patients switching to TAF after long-term treatment with TDF.MethodsA single-center observational study was conducted in Japanese HIV-1-positive patients. TDF was switched to TAF after at least 48 weeks of the treatment so we could evaluate the long-term use of TDF. The primary endpoint was the estimated glomerular filtration rate (eGFR) at 144 weeks of TAF administration. In addition, we predicted the factors that would lead to changes in eGFR after long-term use of TAF.ResultsOf the 125 HIV-1-positive patients who were prescribed TAF at our hospital during the study period, 70 fulfilled the study criteria. The eGFR at the time of switching from TDF to TAF was 81.4 ± 21.1 mL/min/1.73 m2. eGFR improved significantly after 12 weeks of taking TAF but significantly decreased at 96 and 144 weeks. The factors significantly correlated with the decrease in eGFR at 144 weeks on TAF were eGFR and weight at the start of TAF.ConclusionsIn this study, it was confirmed that switching to TAF was effective for Japanese HIV-1-positive patients who had been taking TDF for a long period of time and had a reduced eGFR. It was also found that the transition status depended on the eGFR and weight at the time of switch. Since HIV-1-positive patients in Japan are expected to continue taking TAF for a long time, renal function and body weight should be carefully monitored.

【 授权许可】

CC BY