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J Infect Dis. 2019 Oct 8;220(10):1629-1634. doi: 10.1093/infdis/jiz369.

Use of Contemporary Protease Inhibitors and Risk of Incident Chronic Kidney Disease in Persons With Human Immunodeficiency Virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study.

Author information

1
Rigshospitalet, University of Copenhagen, CHIP, Department of Infectious Diseases, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen, Denmark.
2
Amsterdam University Medical Centres (Location AMC), Department of Global Health and Division of Infectious Diseases, University of Amsterdam.
3
HIV Monitoring Foundation, Amsterdam, The Netherlands.
4
Kirby Institute, University of New South Wales Sydney, Australia.
5
Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, and.
6
Université de Bordeaux, INSERM.
7
Clinic for Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland.
8
Department of Public Health, Nice University Hospital, France.
9
Division of Infectious Diseases, Saint Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
10
Dipartimento di Scienze della Salute, Clinica di Malattie Infettive e Tropicali, Azienda Ospedaliera-Polo Universitario San Paolo, Milan, Italy.
11
ICAP at Columbia University and Harlem Hospital, New York.
12
Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London, London, United Kingdom.

Abstract

BACKGROUND:

It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors.

METHODS:

Participants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last visit plus 6 months, or 1 February 2016. Adjusted Poisson regression was used to assess associations between CKD and the use of ritonavir-boosted atazanavir (ATV/r) or ritonavir-boosted darunavir (DRV/r).

RESULTS:

The incidence of CKD (10.0/1000 person-years of follow-up; 95% confidence interval, 9.5-10.4/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r, but the relation was less clear for DRV/r. After adjustment, only exposure to ATV/r (adjusted incidence rate ratio, 1.4; 95% confidence interval, 1.2-1.6), but not exposure to DRV/r (1.0; .8-1.3), remained significantly associated with CKD.

CONCLUSION:

While DRV/r use was not significantly associated with CKD an increasing incidence with longer ATV/r use was confirmed.

KEYWORDS:

CKD; HIV; adverse drug effect; atazanavir; darunavir; nephrotoxicity; protease inhibitors

PMID:
31504669
PMCID:
PMC6782100
[Available on 2020-10-08]
DOI:
10.1093/infdis/jiz369

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