• Chronic kidney disease
• End-stage renal disease
• Mitochondrial toxicity
• Proximal tubulopathy
• Urine protein-to-creatinine ratio
• β-2-microglobulin

• MOHW112-CDC-C-114-000103 Taiwan Centers for Disease Control

• Humans
• Renal Insufficiency, Chronic/epidemiology
• HIV Infections/drug therapy
• HIV Infections/complications
• HIV Infections/epidemiology
• Tenofovir/therapeutic use
• Anti-HIV Agents/therapeutic use
• Prevalence
• Female
• Male
• CD4 Lymphocyte Count

• bone mineral content
• breastfeeding
• infants
• in‐utero exposure
• pre‐exposure prophylaxis
• tenofovir disoproxil fumarate

• Humans
• Female
• Tenofovir/therapeutic use
• Tenofovir/administration & dosage
• Tenofovir/adverse effects
• Pre-Exposure Prophylaxis/methods
• South Africa
• HIV Infections/prevention & control
• HIV Infections/drug therapy
• Bone Density/drug effects
• Pregnancy
• Infant
• Anti-HIV Agents/therapeutic use
• Anti-HIV Agents/administration & dosage
• Anti-HIV Agents/adverse effects
• Infant, Newborn
• Male
• Adult
• Pregnancy Complications, Infectious/drug therapy
• Pregnancy Complications, Infectious/prevention & control
• Young Adult
• Prenatal Exposure Delayed Effects
• Infectious Disease Transmission, Vertical/prevention & control

• Humans
• Female
• Aged
• Middle Aged
• Aged, 80 and over
• Male
• HIV Infections/complications
• HIV Infections/drug therapy
• HIV Infections/diagnosis
• Emtricitabine/therapeutic use
• Kenya/epidemiology
• Adenine/therapeutic use
• Anti-Retroviral Agents/therapeutic use
• Tenofovir/therapeutic use
• Kidney
• Anti-HIV Agents/therapeutic use
• Alanine/therapeutic use

• Gilead Sciences

• Humans
• Tenofovir/therapeutic use
• HIV Infections/drug therapy
• Anti-HIV Agents/therapeutic use
• Renal Insufficiency/chemically induced
• Cohort Studies
• Acquired Immunodeficiency Syndrome/drug therapy
• Pre-Exposure Prophylaxis/methods
• Emtricitabine/therapeutic use

• Department of Health, Australian Government

• u.s. president’s emergency plan for aids relief

HIV-1-infected Chinese patients who were treated naïve with combination dolutegravir (DTG) and tenofovir disoproxil fumarate (TDF) group, DTG without TDF group, TDF without DTG, as well as patients switched to DTG-containing therapy from other drugs were included.

The dynamics of serum creatinine, cystatin C (CysC) level, eGFR_cr and eGFR_CysC at the baseline, 4 w, 12w, 24w, 36w and 48w for different group of patients were collected and evaluated.

Changes in serum creatinine, levels, eGFR_cr and eGFR_CysC were analyzed among groups and in different time-points. Intra-group correlation coefficient and Bland–Altman plot were used to compare the results of eGFR_cr and eGFR_CysC.

Thirty-seven treated-naïve HIV-patients in combined DTG and TDF group (group 1), 23 in DTG without TDF patients (group 2) and 47 patients on TDF without DTG group (control group, group 3) along with 31 patients whose ART switch to DTG-containing regimens (group 4) were collected. Serum creatinine was significantly elevated in the group 1 and group 2 instead of group 3 from baseline to 48w. Mean decreased change of eGFR calculated by serum creatinine proved the same conclusion. However, there were no differences in serum cystatin C and eGFR_CysC between baseline and at 48 weeks in DTG-containing groups. Moreover, the proportion of eGFRcr decreased over 30% was significantly higher in DTG-treatment group.

We demonstrated the clinical benefits of CysC for assessing the glomerular filtration rate when evaluating renal function in HIV-1-infected patients treated with whether DTG combined with TDF or not.

• the National Key Technologies R&D Program for the 13th Five-year Plan

• HIV
• Impaired kidney function
• Incidence
• Prospective study
• Systematic review

• Female
• Glomerular Filtration Rate
• HIV Infections/drug therapy
• HIV Infections/epidemiology
• Humans
• Incidence
• Kidney
• Male
• Renal Insufficiency

• antiretroviral therapy
• estimated glomerular filtration rate
• northwest Ethiopia
• renal dysfunction
• tenofovir disoproxil fumarate

• external funding

• eGFR (estimated glomerular filtration rate)
• hyperfiltration
• pharmacoepidemiology
• renal impairment
• tenofovir

• human immunodeficiency virus-1
• nonlinear trajectory
• renal function

• Asians
• HIV infection
• Tenofovir
• nephrotoxicity
• tenofovir alafenamide
• tenofovir disoproxil fumarate

• HIV
• aging
• chronic kidney disease
• combination antiretroviral therapy
• stage of HIV infection

• Adolescent
• Adult
• Anti-Retroviral Agents/adverse effects
• Anti-Retroviral Agents/therapeutic use
• CD4 Lymphocyte Count
• Child
• Disease Transmission, Infectious/prevention & control
• Female
• HIV
• HIV Infections/diagnosis
• HIV Infections/drug therapy
• HIV Infections/transmission
• Humans
• Male
• Mass Screening/adverse effects
• Practice Guidelines as Topic
• Time-to-Treatment

• Acquired Immunodeficiency Syndrome/mortality
• Acquired Immunodeficiency Syndrome/prevention & control
• Adolescent
• Adult
• Aged
• Anti-Retroviral Agents/therapeutic use
• CD4 Lymphocyte Count
• Cost of Illness
• Female
• HIV/immunology
• HIV Infections/diagnosis
• HIV Infections/drug therapy
• HIV Infections/epidemiology
• HIV Infections/transmission
• Humans
• Immunoassay
• Infectious Disease Transmission, Vertical/prevention & control
• Male
• Mass Screening/standards
• Middle Aged
• Pregnancy
• Pregnancy Complications, Infectious/diagnosis
• Pregnancy Complications, Infectious/drug therapy
• Risk Factors
• United States/epidemiology
• Young Adult

Background: The burden of the people living with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) is largely borne by communities in Sub-Saharan Africa. The rate of kidney disease is increasing amongst HIV patients and occurs more often in patients with advanced stage of the disease with lower CD₄ counts and associated with a high rate of morbidity and mortality. The objective of this study is to determine the prevalence and predictors of chronic kidney disease (CKD) amongst HIV patients on highly active antiretroviral therapy (HAART) at the University of Calabar Teaching Hospital, Calabar.

Materials and methods: This was a cross-sectional study that was carried out over a 4-month period from May to August 2018. In all, a total of 118 patients with HIV on HAART were recruited into the study in a consecutive manner and their serum creatinine measured with the calculation of estimated glomerular filtration rate (eGFR). Other data collected were sex, age, weight, height, body mass index (BMI), waist hip ratio (WHR), packed cell volume, CD4 count etcetera. Data collected were inputted and analyzed with SPSS version 18, and statistical significance was taken to be p<0.05.

Results: There were more females (69.5%) amongst the HIV participants and the prevalence of CKD was 15.3%. The risk factors seen to be associated with CKD were lower levels of CD4 count below 200 cells/µl, lower PCV, weight, BMI, and eGFR. Also, higher levels of WHR and creatinine were associated with CKD. Factors directly correlated with CKD were weight, BMI and CD4 count levels, while creatinine level was inversely correlated with CKD. However, a logistic regression model showed only creatinine to be a predictor of CKD.

Conclusion: HIV patients on antiretroviral therapy, mainly the highly active antiretroviral therapy (HAART) have a relatively high prevalence of CKD of 15.3% and high level of serum creatinine was predictive of CKD in the logistic regression model in our study.

• HIV
• Nigeria
• South – South
• chronic kidney disease
• predictors

It has been reported that people living with HIV in West Africa exhibited the highest risks for chronic kidney disease (CKD) in the world. Here, we aimed at determining the CKD frequency and changes in kidney function during antiretroviral treatment (ART) in a large cohort of HIV-patients followed in Burkina Faso.

We included ART-naive adults who initiated ART at the Day Care Unit of the Souro Sanou University Hospital between 01/01/2007 and 12/31/2016. We assessed the estimated glomerular filtration rate (eGFR) by serum creatinine using the Modification of Diet in Renal Disease (MDRD) equation. Following the K/DOQI recommendations, CKD was defined as eGFR < 60 ml/min/1.73m² at two consecutive measurements at least 3 months apart. The factors associated with eGFR decline or CKD were identified by mixed linear regression and Cox regression, respectively.

Three thousand, one hundred and thirty-eight patients (72% women) were followed for a median (IQR) of 4.5(2.2–6.9) years. At baseline, median eGFR (IQR) was 110.7(94.4–128.4) ml/min/1.73m² and 93 (3%) patients exhibited eGFR < 60 ml/min/1.73m². The lowest-performing progressions of eGFR during the first year of ART were observed in patients with 40-49 yr. age range (− 8.3[− 11.7;-5.0] ml/min/1.73m², p < 0.001), age ≥ 50 yr. (− 6.2[− 10.7;-1.8] ml/min/1.73m², p = 0.006) and high blood pressure (HBP) (− 28.4[− 46.9;-9.9] ml/min/1.73m², p = 0.003) at ART initiation. Regarding the ART exposure in patients with normal baseline eGFR, zidovudine (AZT) with protease inhibitor (PI) (− 4.7[− 7.7;-1.6] ml/min/1.73m², p = 0.002), tenofovir (TDF) + PI (− 13.1[− 17.4;-8.7] ml/min/1.73m², p < 0.001), TDF without PI (− 3.2[− 5.0;-1.4] ml/min/1.73m², p < 0.001), stavudine (d4T) + PI (− 8.5[− 14.6–2.4] ml/min/1.73m², p = 0.006) and d4T without PI (− 5.0[− 7.6–2.4] ml/min/1.73m², p < 0.001) were associated with poorer eGFR progression. The prevalence of CKD was 0.5% and the incidence was 1.9 [1.3; 2.7] cases/1000 person-years. The risk of CKD was higher in patients with HBP (4.3[1.8;9.9], p = 0.001), 40-49 yr. patients (4.2[1.6;11.2], p = 0.004), ≥50 yr. patients (4.5[1.5;14.1], p = 0.009) and patients exposed to abacavir (ABC) or didanosine (ddI) based ART (13.1[4.0;42.9], p < 0.001).

Our findings do not confirm the high risk of CKD reported in previous studies of West Africans with HIV, but support the recommendations for early initiation of ART and close kidney function monitoring in patients with HBP or aged ≥40 yr.

• Africa
• Antiretroviral treatment
• Burkina Faso
• CKD
• Epidemiology
• HIV

• HIV
• cumulative viral load
• hypertension
• renal disease

Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) significantly reduces the risk of HIV acquisition. TDF is a known nephrotoxin however, renal dysfunction from TDF is mostly reversible following discontinuation.

To describe the renal function, risk factors for renal disease and associated clinical testing practices in a cohort of PrEP patients.

A retrospective review was conducted of all PrEP patients commenced on TDF/FTC at an inner metropolitan sexual health clinic in Sydney, Australia between April 2016 and July 2017, with follow-up data obtained at 3-monthly intervals until 18 months.

525 patients met inclusion criteria. Patients were almost exclusively male and median age was 34 years (IQR: 28 to 42). At baseline, 1.5% had an estimated glomerular filtration rate (eGFR) <70 mL/min/1.73m². A small significant drop in eGFR of -2.5 mL/min/1.73m² (p<0.05) occurred between PrEP commencement and the first follow-up period, followed by a progressive decline in eGFR of -0.38 mL/min/1.73m² per month (95%CI: -0.57 to -0.20; p<0.001). Renal impairment (eGFR <70 mL/min/1.73m²) occurred in 6.5% of patients and persisted across consecutive follow-up periods in five (1.0%) patients. Patients aged ≥40 years had a greater risk of renal impairment than younger patients (HR 3.9, 95%CI: 1.8 to 8.4; p<0.001), despite similar rates of eGFR decline (p = 0.19). PrEP was discontinued in two patients (0.4%) due to renal function concerns.

PrEP use led to an initial drop in eGFR and a more gradual progressive decline subsequently, but significant renal impairment remained uncommon up to 18 months of follow-up.

• Adult
• Age Factors
• Anti-HIV Agents/administration & dosage
• Anti-HIV Agents/adverse effects
• Australia/epidemiology
• Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination/administration & dosage
• Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination/adverse effects
• Female
• Follow-Up Studies
• Glomerular Filtration Rate/drug effects
• HIV Infections/prevention & control
• Humans
• Incidence
• Kidney/drug effects
• Kidney/physiopathology
• Male
• Middle Aged
• Pre-Exposure Prophylaxis/methods
• Renal Insufficiency/chemically induced
• Renal Insufficiency/epidemiology
• Renal Insufficiency/physiopathology
• Retrospective Studies
• Risk Factors

• Association of Medical Microbiology and Infectious Disease (AMMI) Canada
• Canadian Association for the Study of Liver Disease (CASL)
• guidelines
• hepatitis B

Tenofovir disoproxil fumarate (TDF, commonly termed ‘tenofovir’) is the antiretroviral most commonly implicated in antiretroviral-induced nephrotoxicity. As patients on successful antiretroviral therapy (ART) age, their risk for developing renal disease may increase in part because of ART itself, but more importantly, because of HIV-associated and non-HIV-associated comorbidity. Therefore, clinicians need an approach to managing renal disease in people on TDF. TDF as a cause of acute kidney injury (AKI) or chronic kidney disease (CKD) is uncommon, and clinicians should actively exclude other causes (Box 1). In TDF-associated AKI, TDF should be interrupted in all cases, and replaced, or ART interrupted altogether. Tenofovir disoproxil fumarate toxicity can present as AKI or CKD, and as a full or partial Fanconi’s syndrome. TDF has a small but definite negative impact on kidney function (up to a 10% decrease in glomerular filtration rate [GFR]). This occurs because of altered tubular function in those exposed to TDF for treatment and as pre-exposure prophylaxis. Renal function should be assessed using creatinine-based estimated GFR at the time of initiation of TDF, if ART is changed, at 1–3 months, and then ideally every 6–12 months if stable. Specific tests of tubular function are not routinely recommended; in the case of clinical concern, a spot protein or albumin: creatinine ratio is preferable, but in resource-limited settings, urine dipstick can be used. More frequent monitoring may be required in those with established CKD (estimated glomerular filtration rate [eGFR] < 50 mL/min/1.73 m²) or risk factors for kidney disease. The most common risk factors are comorbid hypertension, diabetes, HIV-associated kidney disease, hepatitis B or C co-infection, and TDF in combination with a ritonavir-boosted protease inhibitor. Management of these comorbid conditions must be prioritised in this group. If baseline screening eGFR is < 50 mL/min/1.73 m², abacavir (the preferred option), and dose-adjusted TDF (useful if concomitant hepatitis B), zidovudine or stavudine (d4T) remain alternatives to full-dose TDF. If there is a rapid decline in kidney function (eGFR drops by more than 25% and decreases to < 50 mL/min/1.73 m² from of baseline function), or there is new onset or worsening of proteinuria or albuminuria, clinicians should review ART and other potentially nephrotoxic medications and comorbidity and conduct further testing if indicated. If kidney function does not improve after addressing reversible causes of renal failure, then referral to a nephrologist is appropriate. In the case of severe CKD, timeous referral for planning for renal replacement therapy is recommended. Tenofovir alafenamide, a prodrug of tenofovir, appears to have less renal toxicity and is likely to replace TDF in future.

• AIDS
• FDA
• HIV
• PEPFAR
• TAF
• USFDA
• Global Health
• tentative approval

• hepatitis B vaccination
• kidney transplant
• membranous nephropathy
• survival

Data on renal impairment in sub-Saharan Africa (SSA) remains scarce, determination of renal function is not part of routine assessments. We evaluated renal function and blood pressure in a cohort of people living with HIV (PLWH) on antiretroviral treatment (ART) in the Renal Care Zambia project (ReCaZa).

Using routine data from an HIV outpatient clinic from 2011–2013, we retrospectively estimated the glomerular filtration rate (eGFR, CKD-Epi formula) of PLWH on ART in Lusaka, Zambia. Data were included if adults had had at least one serum creatinine recorded and had been on ART for a minimum of three months. We investigated the differences in eGFR between ART subgroups with and without tenofovir disproxil fumarate (TDF), and applied multivariable linear models to associate ART and eGFR, adjusted for eGFR before ART initiation.

Among 1118 PLWH (63,3% female, mean age 41.8 years, 83% ever on TDF; median duration 1461 [range 98 to 4342] days) on ART, 28.3% had an eGFR <90 ml/min, and 5.5% <60 ml/min at their last measurement. Information on other conditions associated with renal impairment was not systematically documented. Fourteen per cent of the PLWH who later switched to TDF-free ART had an initial eGFR lower 60ml/min. Nineteen percent had first-time hypertensive readings at their last visit. The multivariable models suggest that physicians acted according to guidelines and replaced TDF-containing ART if patients developed moderate/severe renal impairment.

Assessment of renal function in SSA remains a challenge. The vast majority of PLWH benefit from long-term ART, including improved renal function. However, approximately 5% of PLWH on ART may have clinically relevant decreased eGFR, and 27% hypertension. While a routine renal assessment might not be feasible, strategies to identify patients at risk are warranted. Targeted monitoring prior and during ART is recommended, however, should not delay ART access.

• Adult
• Anti-HIV Agents/adverse effects
• Developing Countries
• Female
• Glomerular Filtration Rate/drug effects
• HIV Infections/drug therapy
• HIV Infections/virology
• HIV-1/drug effects
• HIV-1/isolation & purification
• Humans
• Kidney Function Tests
• Male
• Medically Underserved Area
• Middle Aged
• Point-of-Care Testing
• Renal Insufficiency/chemically induced
• Renal Insufficiency/epidemiology
• Retrospective Studies
• Zambia/epidemiology

• Else Kröner-Fresenius-Stiftung

• Antiretroviral therapy
• Cohort profile
• HIV
• Metabolic abnormalities
• Renal complications
• Uganda

• Antiretroviral therapy
• Estimated glomerular filtration rate
• Human immunodeficiency virus
• Proteinuria
• Tenofovir

Tenofovir disoproxil fumarate (TDF)-containing antiretroviral regimens have been associated with an increased incidence of renal and bone adverse outcomes. Here, we estimated the real-world incidence of renal and bone adverse outcomes among patients with HIV infection receiving different TDF-containing single-tablet regimens (STRs).

This cohort study used US health insurance data spanning the years 2008–2014. We identified HIV-infected patients aged ≥18 years (all HIV patients) and those with ≥6 months of continuous enrollment prior to initiating efavirenz/emtricitabine/TDF (EFV/FTC/TDF), rilpivirine/FTC/TDF (RPV/FTC/TDF) or elvitegravir/cobicistat/FTC/TDF (EVG/COBI/FTC/TDF). Renal adverse outcomes were identified using renal International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes. Bone adverse outcomes were identified using ICD-9-CM diagnosis codes for fracture. Incidence rates (IRs) and associated 95% confidence intervals (CIs) were estimated assuming a Poisson distribution, and outcomes between STRs were compared using IR ratios (IRRs) and IR differences (IRDs).

We identified 9876 and 10,383 eligible patients for the renal and fracture analyses, respectively. Observed IRs for renal adverse outcomes were 9.7, 10.5, 13.6, and 18.0 per 1000 person-years among those receiving EFV/FTC/TDF, RPV/FTC/TDF, or EVG/COBI/FTC/TDF, or all HIV patients, respectively. Corresponding values for IRs of fracture were 3.4, 3.6, 7.2, and 4.4 per 1000 person-years, respectively. Renal adverse outcomes with EFV/FTC/TDF were significantly less frequent than with EVG/COBI/FTC/TDF (IRD −3.96; 95% CI: −7.31, −1.06). No IRR differences were identified for the renal analysis. Fractures with EFV/FTC/TDF were significantly less frequent than with EVG/COBI/FTC/TDF (IRR 0.47; 95% CI: 0.27, 0.81 and IRD −3.85; 95% CI: −5.02, −2.78).

In this large real-world database, observed IRs for renal adverse outcomes with TDF-containing STRs were lower or similar to those for all HIV patients, with the lowest IRs observed among patients receiving EFV/FTC/TDF. Compared with all HIV patients, the observed IR for fracture was higher with EVG/COBI/FTC/TDF, comparable with RPV/FTC/TDF, and lower with EFV/FTC/TDF.

• Adult
• Antiretroviral Therapy, Highly Active
• Bone Diseases/epidemiology
• Bone Diseases/etiology
• Comorbidity
• Female
• Follow-Up Studies
• HIV Infections/complications
• HIV Infections/drug therapy
• HIV Infections/epidemiology
• Humans
• Incidence
• Kidney Diseases/epidemiology
• Kidney Diseases/etiology
• Male
• Middle Aged
• Population Surveillance
• Retrospective Studies
• Reverse Transcriptase Inhibitors/adverse effects
• Reverse Transcriptase Inhibitors/therapeutic use
• Risk Factors
• Tablets
• Tenofovir/adverse effects
• Tenofovir/therapeutic use
• United States/epidemiology

• Bristol-Myers Squibb

• Atripla
• Bone disease
• Efavirenz
• Emtricitabine
• Protease inhibitor
• Renal disease
• Tenofovir

Tenofovir (TDF) can cause kidney injury through tubular dysfunction, with or without drop of estimated glomerular filtration rate (eGFR). Whether mild eGFR reductions during treatment should be considered a reason for prompt TDF discontinuation, however, remains unclear.

Patients with normal pre-TDF eGFR levels, who had developed mild renal impairment (i.e., two consecutive eGFR results between 89–60 ml/min) on TDF, were observed until onset of chronic kidney disease (CKD), defined as two eGFR<60 ml/min 3 to 6 months apart. Multivariable Poisson regression analysis was used to investigate whether outcome was associated with current and cumulative use of TDF (modeled as time-varying covariates).

2023 (29%) out of 6984 patients developed mild renal impairment on TDF. Among them, 191 progressed to CKD. The incidence of CKD did not significantly differ during TDF treatment (2.6 per 100 PYFU; 95%CI 2.2–3.2) or after its discontinuation (2.2 per 100 PYFU; 95%CI 1.8–2.6). However, the rate of CKD was significantly higher among patients continuing with TDF treatment compared to those who had discontinued it within 6 months of occurrence of mild renal impairment (aIRR 4, 95%CI 2.4–6.8). In contrast, among patients who had maintained TDF >6 months despite mild renal impairment, current TDF use was not associated with a significantly higher rate of CKD. Other significant predictors of CKD were older age, intravenous drug use, diabetes, hypertension, lower pre-TDF eGFR, higher eGFR drop since TDF introduction and longer exposure to TDF.

Prompt discontinuation of TDF among patients developing mild renal impairment may prevent further progression of renal damage.

• Fractional excretion of filtered phosphate (FePi)
• Hypophosphatemia
• Tenofovir disoproxil fumarate (TDF)

• Adult
• Anti-HIV Agents/adverse effects
• Anti-HIV Agents/therapeutic use
• CD4 Lymphocyte Count/methods
• Creatinine/blood
• Creatinine/urine
• Female
• HIV Infections/blood
• HIV Infections/drug therapy
• HIV Infections/urine
• HIV-1/drug effects
• Humans
• Hypophosphatemia/chemically induced
• Male
• Phosphates/blood
• Phosphates/urine
• Prospective Studies
• Tenofovir/adverse effects
• Tenofovir/therapeutic use

WHO recommends using Tenofovir containing first line antiretroviral therapy (ART), however, Tenofovir has been reported to be associated with renal impairment and dysfunction. We compared renal function among individuals on Tenofovir and those on non-Tenofovir containing ART.

In a cross-sectional study of HIV-Positive adults on ART, at enrolment into a prospective cohort to study the long-term complications of ART in Uganda, information on biophysical measurements, medical history, clinical examination and renal function tests (RFTs) was collected. Fractional Tubular phosphate reabsorption and estimated glomerular filtration rate (eGFR) were calculated. Mean values of RFTs and proportions with abnormal RFTs were compared between non-Tenofovir containing (Non-TDF) and Tenofovir containing (TDF-ART) ART regimen groups using a general linear regression model. Durations of TDF exposure were also compared.

Between July 2013 and October 2014, we enrolled 953 individuals on ART for 6 or more months, median duration on ART was 9.3 years, 385 (40.4 %) were on non-TDF and 568 (59.6 %) on TDF-ART regimens. The proportion of participants with Proteinuria (>30 mg/dl) was higher among the TDF-ART group than the non-TDF ART group. However, in multivariable analysis, there were no significant differences in the adjusted mean differences of eGFR, serum urea, serum creatinine, fractional tubular reabsorption of phosphate and serum phosphates when patients on TDF-ART were compared with those on non-TDF containing ART. There were no differences in renal function even when different durations on Tenofovir were compared.

We found no differences in renal function among patients on Tenofovir and non-Tenofovir containing ART for almost a decade. Tenofovir based first line ART can therefore safely be initiated even in settings without routine renal function monitoring.

• Antiretroviral therapy
• HIV
• Renal function
• Tenofovir
• eGFR

• Adult
• Anti-HIV Agents/adverse effects
• Anti-HIV Agents/therapeutic use
• Creatinine/blood
• Databases, Factual
• Female
• Glomerular Filtration Rate
• HIV Infections/drug therapy
• Humans
• Kidney/drug effects
• Kidney/physiopathology
• Kidney Diseases/chemically induced
• Male
• Middle Aged
• Poisson Distribution
• Proportional Hazards Models
• Prospective Studies
• Risk Factors
• Tenofovir/adverse effects
• Tenofovir/therapeutic use

• U01 AI069907 NIAID NIH HHS
• Foundation for the National Institutes of Health
• National Institute of Child Health and Human Development
• National Cancer Institute
• The Dutch Ministry of Foreign Affairs
• Hong Kong Council for AIDS Trust Fund
• ViiV Healthcare
• The Australian Government Department of Health and Ageing

• Antiretroviral therapy
• adverse drug reactions
• cumulative toxicity
• efavirenz
• emtricitabine
• lamivudine
• overlapping toxicity
• tenofovir
• toxicity

• Adult
• Anti-HIV Agents/administration & dosage
• Anti-HIV Agents/adverse effects
• Anti-HIV Agents/therapeutic use
• CD4 Lymphocyte Count
• Comorbidity
• Dideoxynucleosides/therapeutic use
• Drug Therapy, Combination
• Emtricitabine/therapeutic use
• Female
• Glomerular Filtration Rate/drug effects
• HIV Infections/drug therapy
• HIV Protease Inhibitors/administration & dosage
• HIV Protease Inhibitors/adverse effects
• HIV Protease Inhibitors/therapeutic use
• Humans
• Lamivudine/therapeutic use
• Lopinavir/therapeutic use
• Male
• Middle Aged
• Retrospective Studies
• Reverse Transcriptase Inhibitors/administration & dosage
• Reverse Transcriptase Inhibitors/adverse effects
• Reverse Transcriptase Inhibitors/therapeutic use
• Ritonavir/therapeutic use
• Tenofovir
• Viral Load

• Electrolytes
• HIV/AIDS
• Nutritional supplements
• Randomized-trial
• Renal excretion
• Zambia

• PrEP
• TDF nephrotoxicity
• TDF toxicity
• proximal tubular dysfunction