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Antiretroviral-treated HIV-infected women have similar long-term kidney function trajectories as HIV-uninfected women.
MedLine Citation:
PMID:  23273313     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: Natural history studies suggest increased risk for kidney function decline with HIV, but few studies have made comparisons with HIV-uninfected women. We examined whether HIV treated with highly active antiretroviral therapy (HAART) remains associated with faster kidney function decline in the Women's Interagency HIV Study. Methods: HIV-infected women initiating HAART with (N=105) or without (N=373) tenofovir (TDF) were matched to HIV-uninfected women on calendar and length of follow-up, age, systolic blood pressure, hepatitis C antibody serostatus and diabetes history. Linear mixed models were used to evaluate differences in annual estimated glomerular filtration rate (eGFR). Results: Person-visits were 4,741 and 11,512 for the TDF-treated and nonTDF-treated analyses, respectively. Mean baseline eGFRs were higher among women initiated on TDF-containing HAART and lower among those on TDF-sparing HAART compared to their respective HIV-uninfected matches (P<0.05 for both). HIV-infected women had similar annual rates of eGFR changes as HIV-uninfected matches (P-interaction >0.05 for both). Adjusting for baseline eGFR, mean eGFRs at 1 and 3 years of follow-up among women initiated on TDF-containing HAART were lower than their uninfected matches (-4.98 and -4.26 mL/min|1.73 m2, respectively; P<0.05 for both). Mean eGFR of women initiated on TDF-sparing HAART was lower versus uninfected matches at 5 years (-2.19 mL/min|1.73 m2, P=0.03). Conclusions: HAART-treated HIV-infected women had lower mean eGFRs at follow-up but experienced similar rates of annual eGFR decline as HIV-uninfected women. Tenofovir use in HIV-infected women with normal kidney function did not accelerate long-term kidney function decline relative to HIV-uninfected women.
Authors:
Michelle M Estrella; Alison Gump Abraham; Yuezhou Jing; Rulan Parekh; Phyllis C Tien; Daniel Merenstein; Celeste L Pearce; Kathryn Anastos; Mardge Cohen; Jack Dehovitz; Stephen Gange
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-30
Journal Detail:
Title:  AIDS research and human retroviruses     Volume:  -     ISSN:  1931-8405     ISO Abbreviation:  AIDS Res. Hum. Retroviruses     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8709376     Medline TA:  AIDS Res Hum Retroviruses     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Johns Hopkins School of Medicine, Division of Nephrology, 1830 E. Monument St., Suite 415, Baltimore, Maryland, United States, 21205; mestrel1@jhmi.edu.
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