Glomerular Dysfunction and associated risk factors over 4 to 5 years following ART initiation in Africa
BACKGROUND:The aim of this study was to investigate long-term renal function in HIV-infected adults initiating antiretroviral therapy (ART) with a CD4(+) T-cell count ³ in Africa.
METHODS:This was an observational analysis within the DART trial randomizing 3,316 adults to routine laboratory and clinical monitoring (LCM) or clinically driven monitoring (CDM). Serum creatinine was measured pre-ART (all ≤360 μmol/l), at weeks 4 and 12, then every 12 weeks for 4–5 years; estimated glomerular filtration rate (eGFR) was determined using the Cockcroft-Gault formula. We analysed eGFR changes, and cumulative incidences of eGFR3 months).
RESULTS:At ART initiation, median CD4+ T-cell count was 86 cells/mm³ 1,492 (45%) participants had mild (60 to
CONCLUSIONS:On all regimens and monitoring strategies, severe eGFR impairment was infrequent; differences in eGFR changes were small, suggesting that first-line ART, including tenofovir, can be given safely without routine renal function monitoring.
Stöhr, W.; Reid, A.; Walker, A.S.; Ssali, F.; Munderi, P.; Mambule, I.; Kityo, C.; Grosskurth, H.; Gilks, C.F.; Gibb, D. M.; Hakim, J.; DART Trial team. Glomerular dysfunction and associated risk factors over 4&#8211;5 years following antiretroviral therapy initiation in Africa. Antiviral Therapy (2011) 16 (7) 1011-1020. [DOI: 10.3851/IMP1832]