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Brief Report: Kidney Dysfunction Does Not Contribute Significantly to Antiretroviral Therapy Modification in Treatment-Naive PLWH Receiving Initial ART.

Publication ,  Journal Article
Eaton, EF; Tamhane, A; Davy-Mendez, T; Moore, RD; Mathews, WC; Saag, MS; Mugavero, MJ; Wyatt, CM; Gutierrez, OM
Published in: J Acquir Immune Defic Syndr
May 1, 2019

BACKGROUND: Antiretroviral therapy (ART) durability, time to modification or cessation, has declined. The study objective was to determine whether kidney dysfunction is contributing to reduced durability. METHODS: This retrospective follow-up study of CNICS evaluated treatment-naive PLWH initiating ART between 2007 and 2014. Regimen modification was defined as cessation/modification of any part of the 3-drug ART regimen. We evaluated the role of kidney dysfunction in initial regimen modification as both a mediator and effect measure modifier. Associations of the variables with the ART modification were examined using univariable and multivariable Cox proportional hazard models. RESULTS: Of 4515 PLWH included in the analysis, 1967 modified their ART. Of those receiving TDF-based ART (n = 3888), 1580 (41%) modified their regimen compared with 387 (62%) receiving other regimens. Overall, the median eGFR decreased by 5 mL/min/1.73 m (quartiles: first = -16, third = 0) from baseline to follow-up. Of the 128 patients with low baseline eGFR (<60 mL/min/1.73 m), the final eGFR remained low in 73% while it increased to above 60 mL/min/1.73 m in 27%. Of the 4387 with normal baseline eGFR, only 135 (3%) had a final eGFR <60 mL/min/1.73 m. Those with low eGFR at the baseline and/or final visits were more likely to modify ART than others (hazards ratio = 1.75, 95% confidence interval: 1.39 to 2.19, P < 0.001). Relative to other regimens, TDF-based ART was less likely to be modified when accounting for numerous clinical and demographic traits. CONCLUSIONS: For patients in our study initiated on ART, including TDF-based ART, in the last decade, kidney dysfunction is not a major factor leading to regimen modification.

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Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

May 1, 2019

Volume

81

Issue

1

Start / End Page

e6 / e9

Location

United States

Related Subject Headings

  • Virology
  • Retrospective Studies
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kidney Diseases
  • Humans
  • HIV Infections
  • Glomerular Filtration Rate
  • Female
 

Citation

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Eaton, E. F., Tamhane, A., Davy-Mendez, T., Moore, R. D., Mathews, W. C., Saag, M. S., … Gutierrez, O. M. (2019). Brief Report: Kidney Dysfunction Does Not Contribute Significantly to Antiretroviral Therapy Modification in Treatment-Naive PLWH Receiving Initial ART. J Acquir Immune Defic Syndr, 81(1), e6–e9. https://doi.org/10.1097/QAI.0000000000001999
Eaton, Ellen F., Ashutosh Tamhane, Thibaut Davy-Mendez, Richard D. Moore, W Christopher Mathews, Michael S. Saag, Michael J. Mugavero, Christina M. Wyatt, and Orlando M. Gutierrez. “Brief Report: Kidney Dysfunction Does Not Contribute Significantly to Antiretroviral Therapy Modification in Treatment-Naive PLWH Receiving Initial ART.J Acquir Immune Defic Syndr 81, no. 1 (May 1, 2019): e6–9. https://doi.org/10.1097/QAI.0000000000001999.
Eaton EF, Tamhane A, Davy-Mendez T, Moore RD, Mathews WC, Saag MS, et al. Brief Report: Kidney Dysfunction Does Not Contribute Significantly to Antiretroviral Therapy Modification in Treatment-Naive PLWH Receiving Initial ART. J Acquir Immune Defic Syndr. 2019 May 1;81(1):e6–9.
Eaton, Ellen F., et al. “Brief Report: Kidney Dysfunction Does Not Contribute Significantly to Antiretroviral Therapy Modification in Treatment-Naive PLWH Receiving Initial ART.J Acquir Immune Defic Syndr, vol. 81, no. 1, May 2019, pp. e6–9. Pubmed, doi:10.1097/QAI.0000000000001999.
Eaton EF, Tamhane A, Davy-Mendez T, Moore RD, Mathews WC, Saag MS, Mugavero MJ, Wyatt CM, Gutierrez OM. Brief Report: Kidney Dysfunction Does Not Contribute Significantly to Antiretroviral Therapy Modification in Treatment-Naive PLWH Receiving Initial ART. J Acquir Immune Defic Syndr. 2019 May 1;81(1):e6–e9.

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

May 1, 2019

Volume

81

Issue

1

Start / End Page

e6 / e9

Location

United States

Related Subject Headings

  • Virology
  • Retrospective Studies
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kidney Diseases
  • Humans
  • HIV Infections
  • Glomerular Filtration Rate
  • Female