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논문 기본 정보

자료유형
학술저널
저자정보
Seo Jun-Won (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Kim Kichun (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Jun Kang Il (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Kang Chang Kyung (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Moon Song Mi (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) 송경호 (분당서울대학교병원) Bang Ji Hwan (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.Departmen) Kim Eu Suk (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Kim Hong Bin (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Park Sang Won (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.Departmen) Kim Nam Joong (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Choe Pyoeng Gyun (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Park Wan Beom (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Oh Myoung-don (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.)
저널정보
대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제52권 제3호
발행연도
2020.1
수록면
381 - 388 (8page)

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Background: Tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity is related to high plasma tenofovir concentrations. Tenofovir alafenamide (TAF) is a tenofovir prodrug with 90% lower plasma tenofovir concentrations. The aim of this study was to evaluate changes in tenofovir-induced nephrotoxicity in Human Immunodeficiency Virus (HIV)-positive patients who switched from TDF to TAF. Materials and Methods: We identified all HIV-positive patients who switched from elvitegravir/cobicistat/emtricitabine/TDF to elvitegravir/cobicistat/emtricitabine/TAF at a tertiary hospital. We assessed tubulopathy and renal dysfunction before TDF administration, at the time TAF was used following at least 3 months of TDF use, and 3 months after TAF administration. Tubulopathy was defined by the presence of at least three abnormalities in fractional excretion of phosphate, fractional excretion of uric acid, urinary β2-microglobulin, urinary N-acetyl-β-D-glucosaminidase, glucosuria or proteinuria. Renal dysfunction was defined as decreased by more than 25% in the estimated glomerular filtration rate (eGFR) relative to baseline. Results: In 80 patients, the mean eGFR was 96.8 mL/min/1.73 m2 before administration of TDF, 81.2 (P <0.001) at the time of change to TAF, 90.9 (P <0.001) after TAF administration. Renal dysfunction occurred in 19 patients (23.8%) after TDF use for a median 15 months, 11 (57.9%) of these patients recovered from renal dysfunction after TAF administration. Six patients (7.5%) had tubulopathy before TDF administration, 36 (45.0%) after TDF administration (P <0.001), 12 (15.0%) after TAF administration (P = 0.002). Conclusion: Tenofovir-induced nephrotoxicity in HIV-positive patients receiving TDF was mostly reversible after changing to TAF. Thus, TAF-containing regimens can be administered safely to HIV-positive patients with tenofovir-induced nephrotoxicity.
#Renal dysfunction #Tubulopathy #Tenofovir disoproxil fumarate #Tenofovir alafenamide #HIV

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참고문헌 (25)

참고문헌 신청
Ryom L / 2018 / Highlights of the 2017 European AIDS Clinical Society (EACS) guidelines for the treatment of adult HIV-positive persons version 9.0 / HIV Med 19:309~315 google schola Molina JM / 2015 / On-demand preexposure prophylaxis in men at high risk for HIV-1 infection / N Engl J Med 373:2237~2246 google schola Landovitz RJ / 2009 / Clinical practice. Postexposure prophylaxis for HIV infection / N Engl J Med 361:1768~1775 google schola Verhelst D / 2002 / Fanconi syndrome and renal failure induced by tenofovir : a first case report / Am J Kidney Dis 40:1331~1333 google schola Schaaf B / 2003 / Acute renal failure associated with tenofovir treatment in a patient with acquired immunodeficiency syndrome / Clin Infect Dis 37:e41~e43 google schola

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