Imperial College London
Portrait Picture

ProfessorJeremyLevy

Faculty of Medicine, Department of Immunology and Inflammation

Professor of Practice (Medicine)
 
 
 
//

Contact

 

+44 (0)20 3313 7397j.levy

 
 
//

Location

 

Hammersmith HospitalHammersmith Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Hamzah:2017:10.1016/j.jinf.2017.01.010,
author = {Hamzah, L and Jose, S and Booth, JW and Hegazi, A and Rayment, M and Bailey, A and Williams, DI and Hendry, BM and Hay, P and Jones, R and Levy, JB and Chadwick, DR and Johnson, M and Sabin, CA and Post, FA},
doi = {10.1016/j.jinf.2017.01.010},
journal = {Journal of Infection},
pages = {492--500},
title = {Treatment-limiting renal tubulopathy in patients treated with tenofovir disoproxil fumarate.},
url = {http://dx.doi.org/10.1016/j.jinf.2017.01.010},
volume = {74},
year = {2017}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: Tenofovir disoproxil fumarate (TDF) is widely used in the treatment or prevention of HIV and hepatitis B infection. TDF may cause renal tubulopathy in a small proportion of recipients. We aimed to study the risk factors for developing severe renal tubulopathy. METHODS: We conducted an observational cohort study with retrospective identification of cases of treatment-limiting tubulopathy during TDF exposure. We used multivariate Poisson regression analysis to identify risk factors for tubulopathy, and mixed effects models to analyse adjusted estimated glomerular filtration rate (eGFR) slopes. RESULTS: Between October 2002 and June 2013, 60 (0.4%) of 15,983 patients who had received TDF developed tubulopathy after a median exposure of 44.1 (IQR 20.4, 64.4) months. Tubulopathy cases were predominantly male (92%), of white ethnicity (93%), and exposed to antiretroviral regimens that contained boosted protease inhibitors (PI, 90%). In multivariate analysis, age, ethnicity, CD4 cell count and use of didanosine or PI were significantly associated with tubulopathy. Tubulopathy cases experienced significantly greater eGFR decline while receiving TDF than the comparator group (-6.60 [-7.70, -5.50] vs. -0.34 [-0.43, -0.26] mL/min/1.73 m(2)/year, p < 0.0001). CONCLUSIONS: Older age, white ethnicity, immunodeficiency and co-administration of ddI and PI were risk factors for tubulopathy in patients who received TDF-containing antiretroviral therapy. The presence of rapid eGFR decline identified TDF recipients at increased risk of tubulopathy.
AU  - Hamzah,L
AU  - Jose,S
AU  - Booth,JW
AU  - Hegazi,A
AU  - Rayment,M
AU  - Bailey,A
AU  - Williams,DI
AU  - Hendry,BM
AU  - Hay,P
AU  - Jones,R
AU  - Levy,JB
AU  - Chadwick,DR
AU  - Johnson,M
AU  - Sabin,CA
AU  - Post,FA
DO  - 10.1016/j.jinf.2017.01.010
EP  - 500
PY  - 2017///
SN  - 1532-2742
SP  - 492
TI  - Treatment-limiting renal tubulopathy in patients treated with tenofovir disoproxil fumarate.
T2  - Journal of Infection
UR  - http://dx.doi.org/10.1016/j.jinf.2017.01.010
UR  - http://www.ncbi.nlm.nih.gov/pubmed/28130143
UR  - http://hdl.handle.net/10044/1/44686
VL  - 74
ER  -
Download