Effects of a switch from tenofovir- to abacavir-based antiretroviral therapy, with or without atazanavir, on renal function

Introduction: Tenofovir disoproxil fumarate (TDF)-associated renal dysfunction may abate when TDF is replaced with abacavir (ABC). The extent to which the third drug atazanavir contributes to renal dysfunction is unclear. Methods: A retrospective analysis was conducted on adults who had plasma viral load (pVL) < 200 copies/mL for [greater than or equal to] six months while receiving TDF/lamivudine (3TC)--or TDF/emtricitabine (FTC)--based antiretroviral therapy (ART), then switched to ABC/3TC while retaining the third drug in the ART regimen. CD4, pVL, creatinine, estimated glomerular filtration rate (eGFR), serum phosphorus, urine albumin to creatinine ratio and serum lipids were compared between pre-switch baseline and 3, 6 and 12 months after the switch to ABC. Results: A total of 286 patients switched from TDF to ABC between 2004 and 2014: 232 (81%) male, median age 48 years (interquartile range (IQR) 42, 56). The third drug was atazanavir ([+ or -] ritonavir) in 141 (49%) cases. The pVL was Conclusions: Viral suppression was maintained among patients who switched from TDF/3TC or TDF/FTC to ABC/3TC. Serum creatinine and eGFR improved up to 12 months after switching to ABC/3TC, irrespective of whether or not patients were also receiving atazanavir [+ or -] ritonavir. Keywords: HIV; tenofovir; abacavir; atazanavir; renal; renal dysfunction; HAART.
Introduction The appropriate use of active antiretroviral therapy (ART) among HIV-1-infected individuals leads to the suppression of viral replication, sustained undetectable plasma viral load (pVL) and CD4 recovery. ART thus [...]