Effect of Universal Testing and Treatment on HIV Incidence - HPTN 071 (PopART)
Neural-Tube Defects and Antiretroviral Treatment Regimens in Botswana
Virological remission after antiretroviral therapy interruption in female African HIV seroconverters
Do people living with HIV experience greater age advancement than their HIV-negative counterparts?
Prednisone for the Prevention of Paradoxical Tuberculosis-Associated IRIS
Repeat testing of low-level HIV-1 RNA: assay performance and implementation in clinical trials
Enhanced Prophylaxis plus Antiretroviral Therapy for Advanced HIV Infection in Africa
Kidney Diseases Associated with Human Immunodeficiency Virus Infection
A Randomized, Controlled Trial of a Behavioral Weight Loss Program for HIV-Infected Patients
CD32a is a marker of a CD4 T-cell HIV reservoir harbouring replication-competent proviruses
Life expectancy in HIV-positive persons in Switzerland: matched comparison with general population
Successful Prevention of Transmission of Integrase Resistance in the Swiss HIV Cohort Study
Immunologic Biomarkers, Morbidity, and Mortality in Treated HIV Infection
Rosuvastatin slows progression of subclinical atherosclerosis in patients with treated HIV infection
Antiretroviral therapy for the prevention of HIV-1 transmission
HIV Transmission Risk Persists During the First 6 Months of Antiretroviral Therapy
Review of the Efficacy, Safety, and Pharmacokinetics of Raltegravir in Pregnancy
Use of Abacavir and Risk of Cardiovascular Disease Among HIV-Infected Individuals
Patterns of Cardiovascular Mortality for HIV-Infected Adults in the United States: 1999 to 2013
Adjunctive Dexamethasone in HIV-Associated Cryptococcal Meningitis
Outcomes of HIV-associated Hodgkin lymphoma in the era of antiretroviral therapy
CD8 T-Cell Expansion and Inflammation Linked to CMV Coinfection in ART-treated HIV Infection
Ongoing HIV Replication Replenishes Viral Reservoirs During Therapy
Incidence and progression of coronary artery calcium in HIV-infected and HIV-uninfected men
Levels of intracellular HIV-DNA in patients with suppressive antiretroviral therapy
Course and Clinical Significance of CD8+ T-Cell Counts in a Large Cohort of HIV-Infected Individuals
Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients
Predicting the outcomes of treatment to eradicate the latent reservoir for HIV-1
A chronic kidney disease risk score to determine tenofovir safety in a prospective cohort of HIV-positive male veterans
Published by François RAFFI
Updated: 1 February, 2015
The objective of this study was to develop a scoring system to predict 5-year risk of developing chronic kidney disease in HIV-infected individuals and to estimate difference in risk associated with tenofovir disoproxil fumarate use. 21,590 HIV-infected men from the Veterans Health Administration initiating antiretroviral therapy from 1997 to 2010 were selected for this analysis. During a median follow-up of 6.3 years, 2,059 chronic kidney disease events occurred. Chronic kidney disease was defined as the first occurrence of an estimated glomerular filtration rate below < 60 ml/min per 1.73m 2 . A point-based score was developed using multi-variable Cox regression models. Dominant contributors to the chronic kidney disease risk score were traditional kidney risk factors (age, glucose, systolic blood pressure, hypertension, triglycerides, proteinuria), as well as CD4 + cell count, while HIV RNA was not. The overall 5-year event rate was 7.7% in tenofovir users and 3.8% in nonusers (overall adjusted hazard ratio 2.0, 95% confidence interval 1.8–2.2). There was a progressive increase in 5-year chronic kidney disease risk, ranging from less than 1% to 16% in nonusers of tenofovir, and from 1.4 to 21.4% among tenofovir users. The duration of tenofovir exposure and the increased risk score were associated with higher risk of chronic kidney disease.
In conclusion, the chronic kidney disease risk score can be used to predict an HIV-infected individual's absolute risk of developing chronic kidney disease over 5 years and may facilitate clinical decision-making around tenofovir use. The limitations of this study are its observational nature, the absence of consideration of active HCV infection in the analysis. This risk score algorithm needs to be validated in an independent cohort and doesn't substitute for regular clinical and laboratory monitoring of patients on tenofovir.