Likelihood of development renal dysfunction after one year of treatment with tenofovir(TDF) in HIV/AIDS patients at the UTH: An analytical cross-section study
Date
2015-04-13
Authors
Chabala, Freeman W.
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Abstract
Studies have suggested that Sub-Sahara Africans are prone to HIV-related renal dysfunction. A study done in Zambia showed increased deaths among HIV/AIDS patients who had renal dysfunction. Tenofovir Disoproxil Fumarate (TDF) one of the first line antiretroviral drugs in Zambia, has been associated with renal tubulopathy and nephrotoxicity in many studies. In Zambia, TDF has been in use since 2007. This study was set out to determine whether TDF had similar Nephrotoxic effects in patients receiving TDF- based regimen at the largest Antiretroviral Therapy (ART) Centre in Lusaka. It aimed at determining the likelihood of patients with no renal dysfunction (CLcr method) at initiation of therapy developing renal dysfunction after 1 year of treatment with TDF- based regimen compared to those on non- TDF- based regimen (these patients were either on Stavudine (D4T)- based regimen or Zidovudine (AZT)- based regimen).
An analytical cross- sectional study involved analysis of data obtained from 549 randomly selected HIV/AIDS patient files that were started on ART between September, 2007 and January, 2013. Out of the 549 patients, 275 patients were on TDF- based regimen and 274 patients were on non- TDF- based regimen.
Findings showed a significantly larger number of participants on TDF developing renal dysfunction from having no renal dysfunction at baseline compared to those on non- TDF- based regimen; 51 out of 180 verses 8 out of 207, P< 0.001. Upon controlling for age and sex, logistic regression model showed that HIV/AIDS patients on TDF- based regimen were 8.77 times more likely to develop renal dysfunction after one year of therapy from having no renal dysfunction at baseline compared to those on non- TDF- based regimen.
It was concluded that treatment with TDF- based regimen was strongly associated with developing renal dysfunction after 1 year of treatment compared to non TDF- based regimen. There is need for follow up of patients on TDF- based regimen or therapy modification to reduce cases of renal dysfunction in patients on treatment thereby allowing them benefit fully by the treatment.
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Keywords
Renal Failure , Kidney Failure