Send to

Choose Destination
Expert Rev Anti Infect Ther. 2016 Aug;14(8):777-83. doi: 10.1080/14787210.2016.1202759. Epub 2016 Jul 14.

Effect of changing from first- to second-line antiretroviral therapy on renal function: a retrospective study based on data from a single health facility in Namibia.

Author information

a School of Pharmacy, Faculty of Health Sciences , University of Namibia , Windhoek , Namibia.
b Department of Pharmacy , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
c Department of Laboratory Medicine, Division of Clinical Pharmacology , Karolinska Institutet, Karolinska University Hospital Huddinge , Stockholm , Sweden.
d Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , UK.

Erratum in

  • Erratum. [Expert Rev Anti Infect Ther. 2016]



Tenofovir disoproxil fumarate (TDF) and lopinavir/ritonavir (LPV/r) can cause renal impairment with this combination co-administered during second-line combination antiretroviral therapy (cART) potentially associated with greater risk of nephrotoxicity. As a result, the aim of this study is to assess effects of second-line cART on renal function.


Retrospective longitudinal study in patients receiving cART.


71 patients received TDF, zidovudine or stavudine, each combined with 3TC/NVP or 3TC/EFV. Before second-line cART, 46.5% had abnormal kidney function. First-line cART had no relationship with calculated creatinine clearance (CrCl). During second-line cART, more males than females had abnormal renal function and more females experienced increases in CrCl. Calculated CrCl during second-line cART related strongly with CrCl during first-line cART. Time spent on cART had a weak relationship with CrCl.


Patients on first-line cART for several years without renal impairment may experience new onset impairment during second line cART. Patients with pre-existing renal impairment just before switching to second-line cART may experience a further decline.


Namibia; combination antiretroviral therapy; creatinine clearance; drug utilisation study; renal function

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Taylor & Francis
Loading ...
Support Center