Titre :

Changes in kidney function among men having sex with men starting on demand tenofovir disoproxil fumarate - emtricitabine for HIV pre-exposure prophylaxis.

Auteur(s) :

Liegeon, Geoffroy [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Antoni, Guillemette [Auteur]
Institut National de la Santé et de la Recherche Médicale [INSERM]
Pialoux, Gilles [Auteur]
CHU Tenon [AP-HP]
Capitant, Catherine [Auteur]
Institut National de la Santé et de la Recherche Médicale [INSERM]
Cotte, Laurent [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Charreau, Isabelle [Auteur]
Institut National de la Santé et de la Recherche Médicale [INSERM]
Tremblay, Cécile [Auteur]
Centre Hospitalier de l'Université de Montréal [CHUM]
Cua, Eric [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Raffi, François [Auteur]
Hôtel-Dieu de Nantes
Meyer, Laurence [Auteur]
Institut National de la Santé et de la Recherche Médicale [INSERM]
Molina, Jean-Michel [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]

Titre de la revue :

Journal of the International AIDS Society

Nom court de la revue :

J Int AIDS Soc

Numéro :

23

Pagination :

e25420

Date de publication :

2020-02-29

ISSN :

1758-2652

Mot(s)-clé(s) en anglais :

PrEP
on-demand
intermittent
kidney
eGFR
tenofovir
HIV

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Introduction Daily pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is associated with a small but statistically significant decrease in estimated glomerular filtration rate (eGFR). ...
Lire la suite >Introduction Daily pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is associated with a small but statistically significant decrease in estimated glomerular filtration rate (eGFR). We assessed the renal safety of on-demand PrEP with TDF/FTC in HIV-1 uninfected men. Methods We used data from the randomized double-blind placebo-controlled ANRS-IPERGAY trial and its open-label extension conducted between February 2012 and June 2016 among HIV-uninfected MSM starting on-demand PrEP. Using linear mixed model, we evaluated the mean eGFR decline from baseline over time and determined risks factors associated with eGFR decline during the study. Results During the blind phase, with a median follow-up of 9.4 months, the mean decline slope of eGFR from baseline was −0.88 and −1.53 mL/min/1.73 m2 per year in the placebo (n = 201) and the TDF/FTC group (n = 198) respectively, with a slope difference of 0.65 mL/min/1.73 m2 per year (p = 0.27). Including both phases, 389 participants started on-demand TDF/FTC with a median follow-up of 19.2 months and a mean decline of eGFR from baseline of −1.14 mL/min/1.73 m2 per year (p < 0.001). The slope of eGFR reduction was not significantly different in participants with baseline eGFR ≤ 90 mL/min/1.73 m2 (p = 0.44), age >40 years (p = 0.24) or hypertension (p = 0.21). There was a dose-response relationship between recent tenofovir exposure and lower eGFR when considering the number of pills taken in the two months prior the visit (eGFR difference of −0.88 mL/min/1.73 m2 between >15 pills/month vs. ≤15 pills/month, p < 0.01) or plasma tenofovir concentrations at the visit (eGFR difference compared to ≤2 ng/mL: >2 to ≤10ng/mL: −0.98 mL/min/1.73 m2, >10 to ≤40ng/mL: −1.28 mL/min/1.73 m2, >40 ng/mL: −1.82 mL/min/1.73 m2, p < 0.001). Three participants discontinued TDF/FTC for eGFR < 60 mL/min/1.73 m2 during the OLE phase. No case of Fanconi syndrome was reported. Conclusions The renal safety of on-demand PrEP with TDF/FTC was good. The overall reduction and intermittent exposure to TDF/FTC may explain this good renal safety.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2023-11-15T09:18:05Z
2024-01-11T08:36:21Z