Evolution of estimated glomerular filtration rate in HIV/HCV-coinfected patients who received direct-acting antivirals: A multicenter retrospective study |
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| Affiliation: | 1. Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;2. Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan;3. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;4. Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan;5. Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;6. Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan;7. Department of Internal Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan;8. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;9. Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan;10. Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;11. Department of Internal Medicine, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan;12. Department of Internal Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan;13. Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan;14. Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan;15. Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan;p. Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan;q. Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;r. College of Medicine, Chang Gung University, Kaohsiung, Taiwan;s. Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan |
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| Abstract: | BackgroundThe short-term impact of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) combined with antiretroviral therapy (ART) on renal function in patients with HIV/HCV-coinfection remains controversial.MethodsThis multicenter, retrospective study aimed to sequentially record the estimated glomerular filtration rate (eGFR) at baseline, end of therapy (EOT), 12 weeks off-treatment (SVR12), and at time points after SVR12 (post-SVR12) and to identify the factors associated with an eGFR decline to <60 ml/min/1.73 m2 in HIV/HCV-coinfected patients receiving DAAs. The evolution of mean eGFRs between different ART and DAAs combinations among patients of different HIV transmission routes were compared using a generalized linear mixed effects model. The periods between baseline and EOT, between EOT and post-SVR12, and between baseline and post-SVR12 were defined as the on-treatment, post-treatment, and all-course periods, respectively. Acute kidney disease (AKD) was defined as a decline of eGFR to <60 ml/min/1.73 m2.ResultA total of 445 patients with baseline eGFRs >60 ml/min/1.73 m2 were included. We found that eGFRs declined during the on-treatment period in the tenofovir-containing ART and SOF-based DAA groups. There were no differences in the slope coefficient during the on-treatment and post-treatment periods among all risk groups except for people who inject drug. Increasing age and plasma HIV RNA >20 copies/ml before DAA treatment were factors independently associated with AKD during the on-treatment period while increasing age was independently associated with AKD during the all-course period.ConclusionOnly increasing age was an independent factor associated with AKD among HIV/HCV-coinfected patients during and after DAA treatments. |
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| Keywords: | Renal function Acute kidney disease Ageing Sofosbuvir Tenofovir |
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