Kidney Function in HIV/HBV Coinfected People on Tenofovir

[Guest guest]

http://www.hivandhepatitis.com/2011_conference/easl2011/docs/0419_2010_a.html

HIV and Hepatitis.com Coverage of the

46th Annual Meeting of the European

Association for the Study of the Liver

March 30 - April 3, 2011, Berlin, Germany

Kidney Function in HIV/HBV Coinfected People on Tenofovir

SUMMARY: Impaired kidney function among people with HIV, HBV, and HIV/HBV

coinfection taking tenofovir mainly occurred in those with pre-existing risk

factors, researchers reported at EASL 2011.

By Liz Highleyman

Tenofovir (Viread, also in the Truvada and Atripla coformulations) is highly

effective in treating both hepatitis B virus (HBV) and HIV, but it can cause

kidney impairment in susceptible individuals.

As reported in a poster at the European Association for the Study of the Liver's

International Liver Congress (EASL 2011) this month in Berlin, French

researchers compared changes in glomerular filtration rate (GFR) -- a laboratory

measure of kidney function -- in HIV monoinfected, HBV monoinfected, and HIV/HBV

coinfected patients treated with tenofovir.

This retrospective analysis included 194 HIV positive patients receiving

first-line antiretroviral therapy, 50 people with hepatitis B alone, and 85 with

HIV/HBV coinfection. All participants had used tenofovir for more than 1 year.

As a group, the coinfected patients had taken tenofovir significantly longer

than those with HIV or HBV alone (3.9 years vs 2.4 years, respectively).

More than 70% of study participants were men and about one-third were of African

descent (a group at higher risk for kidney diseases). People with HBV were on

average older, less likely to be African, and had lower baseline GFR. Patients

with decompensated cirrhosis, liver cancer, pre-existing kidney insufficiency,

and liver transplant recipients were excluded.

Results

Over a median follow-up period of 2.7 years, the median GFR decrease according

to the MDRD equation was -4.9 mL/min.

In a multivariate analysis, significant predictors of GFR decrease in the study

population as a whole were:

Older age (P = 0.0002);

African origin (P < 0.0001);

Poorer GFR at baseline (P < 0.0001);

Longer duration of tenofovir use (P = 0.02).

In contrast, arterial hypertension (high blood pressure), diabetes, and type of

infection (HIV, HBV, or HIV/HBV) were not independent risk factors.

Among HIV monoinfected and HIV/HBV coinfected participants, the following

factors remained significantly associated with GFR decline:

Older age (P < 0.0001);

African origin (P = 0.0004);

Poorer baseline GFR (P < 0.0001);

Longer tenofovir duration (P = 0.007).

Other variables, including HIV transmission risk factor, CDC HIV/AIDS stage,

CD4 T-cell count, and HIV viral load were not significant risk factors.

Among people with HBV alone or HIV/HBV coinfection, significant predictors

were:

Older age (P = 0.03);

African origin (P = 0.004);

Poorer baseline GFR (P < 0.0001);

HBV viral load > 2000 IU/mL (P = 0.04).

Other variables including HBV transmission risk factor and liver fibrosis stage

were not independent predictors.

Based on these findings, the researchers concluded, " GFR decline under tenofovir

therapy appears mainly associated with older age, non-African origin, higher

baseline GFR and longer tenofovir duration. The effect of baseline HBV DNA

deserves further study. "

Investigator affiliations: Hospices Civils de Lyon, Lyon, France; INSERM U871,

Université Lyon 1, Lyon, France.

4/19/11

Reference

L Cotte, M-A Le Pogam, J-B Okon, et al. Evolution of glomerular filtration rate

in HIV-infected, HIV-HBV coinfected and HBV-infected patients receiving

tenofovir. 46th Annual Meeting of the European Association for the Study of the

Liver (EASL 2011). Berlin. March 30-April 3. Abstract 587.

[Guest guest]

http://www.hivandhepatitis.com/2011_conference/easl2011/docs/0419_2010_a.html

HIV and Hepatitis.com Coverage of the

46th Annual Meeting of the European

Association for the Study of the Liver

March 30 - April 3, 2011, Berlin, Germany

Kidney Function in HIV/HBV Coinfected People on Tenofovir

SUMMARY: Impaired kidney function among people with HIV, HBV, and HIV/HBV

coinfection taking tenofovir mainly occurred in those with pre-existing risk

factors, researchers reported at EASL 2011.

By Liz Highleyman

Tenofovir (Viread, also in the Truvada and Atripla coformulations) is highly

effective in treating both hepatitis B virus (HBV) and HIV, but it can cause

kidney impairment in susceptible individuals.

As reported in a poster at the European Association for the Study of the Liver's

International Liver Congress (EASL 2011) this month in Berlin, French

researchers compared changes in glomerular filtration rate (GFR) -- a laboratory

measure of kidney function -- in HIV monoinfected, HBV monoinfected, and HIV/HBV

coinfected patients treated with tenofovir.

This retrospective analysis included 194 HIV positive patients receiving

first-line antiretroviral therapy, 50 people with hepatitis B alone, and 85 with

HIV/HBV coinfection. All participants had used tenofovir for more than 1 year.

As a group, the coinfected patients had taken tenofovir significantly longer

than those with HIV or HBV alone (3.9 years vs 2.4 years, respectively).

More than 70% of study participants were men and about one-third were of African

descent (a group at higher risk for kidney diseases). People with HBV were on

average older, less likely to be African, and had lower baseline GFR. Patients

with decompensated cirrhosis, liver cancer, pre-existing kidney insufficiency,

and liver transplant recipients were excluded.

Results

Over a median follow-up period of 2.7 years, the median GFR decrease according

to the MDRD equation was -4.9 mL/min.

In a multivariate analysis, significant predictors of GFR decrease in the study

population as a whole were:

Older age (P = 0.0002);

African origin (P < 0.0001);

Poorer GFR at baseline (P < 0.0001);

Longer duration of tenofovir use (P = 0.02).

In contrast, arterial hypertension (high blood pressure), diabetes, and type of

infection (HIV, HBV, or HIV/HBV) were not independent risk factors.

Among HIV monoinfected and HIV/HBV coinfected participants, the following

factors remained significantly associated with GFR decline:

Older age (P < 0.0001);

African origin (P = 0.0004);

Poorer baseline GFR (P < 0.0001);

Longer tenofovir duration (P = 0.007).

Other variables, including HIV transmission risk factor, CDC HIV/AIDS stage,

CD4 T-cell count, and HIV viral load were not significant risk factors.

Among people with HBV alone or HIV/HBV coinfection, significant predictors

were:

Older age (P = 0.03);

African origin (P = 0.004);

Poorer baseline GFR (P < 0.0001);

HBV viral load > 2000 IU/mL (P = 0.04).

Other variables including HBV transmission risk factor and liver fibrosis stage

were not independent predictors.

Based on these findings, the researchers concluded, " GFR decline under tenofovir

therapy appears mainly associated with older age, non-African origin, higher

baseline GFR and longer tenofovir duration. The effect of baseline HBV DNA

deserves further study. "

Investigator affiliations: Hospices Civils de Lyon, Lyon, France; INSERM U871,

Université Lyon 1, Lyon, France.

4/19/11

Reference

L Cotte, M-A Le Pogam, J-B Okon, et al. Evolution of glomerular filtration rate

in HIV-infected, HIV-HBV coinfected and HBV-infected patients receiving

tenofovir. 46th Annual Meeting of the European Association for the Study of the

Liver (EASL 2011). Berlin. March 30-April 3. Abstract 587.

[Guest guest]

http://www.hivandhepatitis.com/2011_conference/easl2011/docs/0419_2010_a.html

HIV and Hepatitis.com Coverage of the

46th Annual Meeting of the European

Association for the Study of the Liver

March 30 - April 3, 2011, Berlin, Germany

Kidney Function in HIV/HBV Coinfected People on Tenofovir

SUMMARY: Impaired kidney function among people with HIV, HBV, and HIV/HBV

coinfection taking tenofovir mainly occurred in those with pre-existing risk

factors, researchers reported at EASL 2011.

By Liz Highleyman

Tenofovir (Viread, also in the Truvada and Atripla coformulations) is highly

effective in treating both hepatitis B virus (HBV) and HIV, but it can cause

kidney impairment in susceptible individuals.

As reported in a poster at the European Association for the Study of the Liver's

International Liver Congress (EASL 2011) this month in Berlin, French

researchers compared changes in glomerular filtration rate (GFR) -- a laboratory

measure of kidney function -- in HIV monoinfected, HBV monoinfected, and HIV/HBV

coinfected patients treated with tenofovir.

This retrospective analysis included 194 HIV positive patients receiving

first-line antiretroviral therapy, 50 people with hepatitis B alone, and 85 with

HIV/HBV coinfection. All participants had used tenofovir for more than 1 year.

As a group, the coinfected patients had taken tenofovir significantly longer

than those with HIV or HBV alone (3.9 years vs 2.4 years, respectively).

More than 70% of study participants were men and about one-third were of African

descent (a group at higher risk for kidney diseases). People with HBV were on

average older, less likely to be African, and had lower baseline GFR. Patients

with decompensated cirrhosis, liver cancer, pre-existing kidney insufficiency,

and liver transplant recipients were excluded.

Results

Over a median follow-up period of 2.7 years, the median GFR decrease according

to the MDRD equation was -4.9 mL/min.

In a multivariate analysis, significant predictors of GFR decrease in the study

population as a whole were:

Older age (P = 0.0002);

African origin (P < 0.0001);

Poorer GFR at baseline (P < 0.0001);

Longer duration of tenofovir use (P = 0.02).

In contrast, arterial hypertension (high blood pressure), diabetes, and type of

infection (HIV, HBV, or HIV/HBV) were not independent risk factors.

Among HIV monoinfected and HIV/HBV coinfected participants, the following

factors remained significantly associated with GFR decline:

Older age (P < 0.0001);

African origin (P = 0.0004);

Poorer baseline GFR (P < 0.0001);

Longer tenofovir duration (P = 0.007).

Other variables, including HIV transmission risk factor, CDC HIV/AIDS stage,

CD4 T-cell count, and HIV viral load were not significant risk factors.

Among people with HBV alone or HIV/HBV coinfection, significant predictors

were:

Older age (P = 0.03);

African origin (P = 0.004);

Poorer baseline GFR (P < 0.0001);

HBV viral load > 2000 IU/mL (P = 0.04).

Other variables including HBV transmission risk factor and liver fibrosis stage

were not independent predictors.

Based on these findings, the researchers concluded, " GFR decline under tenofovir

therapy appears mainly associated with older age, non-African origin, higher

baseline GFR and longer tenofovir duration. The effect of baseline HBV DNA

deserves further study. "

Investigator affiliations: Hospices Civils de Lyon, Lyon, France; INSERM U871,

Université Lyon 1, Lyon, France.

4/19/11

Reference

L Cotte, M-A Le Pogam, J-B Okon, et al. Evolution of glomerular filtration rate

in HIV-infected, HIV-HBV coinfected and HBV-infected patients receiving

tenofovir. 46th Annual Meeting of the European Association for the Study of the

Liver (EASL 2011). Berlin. March 30-April 3. Abstract 587.

[Guest guest]

http://www.hivandhepatitis.com/2011_conference/easl2011/docs/0419_2010_a.html

HIV and Hepatitis.com Coverage of the

46th Annual Meeting of the European

Association for the Study of the Liver

March 30 - April 3, 2011, Berlin, Germany

Kidney Function in HIV/HBV Coinfected People on Tenofovir

SUMMARY: Impaired kidney function among people with HIV, HBV, and HIV/HBV

coinfection taking tenofovir mainly occurred in those with pre-existing risk

factors, researchers reported at EASL 2011.

By Liz Highleyman

Tenofovir (Viread, also in the Truvada and Atripla coformulations) is highly

effective in treating both hepatitis B virus (HBV) and HIV, but it can cause

kidney impairment in susceptible individuals.

As reported in a poster at the European Association for the Study of the Liver's

International Liver Congress (EASL 2011) this month in Berlin, French

researchers compared changes in glomerular filtration rate (GFR) -- a laboratory

measure of kidney function -- in HIV monoinfected, HBV monoinfected, and HIV/HBV

coinfected patients treated with tenofovir.

This retrospective analysis included 194 HIV positive patients receiving

first-line antiretroviral therapy, 50 people with hepatitis B alone, and 85 with

HIV/HBV coinfection. All participants had used tenofovir for more than 1 year.

As a group, the coinfected patients had taken tenofovir significantly longer

than those with HIV or HBV alone (3.9 years vs 2.4 years, respectively).

More than 70% of study participants were men and about one-third were of African

descent (a group at higher risk for kidney diseases). People with HBV were on

average older, less likely to be African, and had lower baseline GFR. Patients

with decompensated cirrhosis, liver cancer, pre-existing kidney insufficiency,

and liver transplant recipients were excluded.

Results

Over a median follow-up period of 2.7 years, the median GFR decrease according

to the MDRD equation was -4.9 mL/min.

In a multivariate analysis, significant predictors of GFR decrease in the study

population as a whole were:

Older age (P = 0.0002);

African origin (P < 0.0001);

Poorer GFR at baseline (P < 0.0001);

Longer duration of tenofovir use (P = 0.02).

In contrast, arterial hypertension (high blood pressure), diabetes, and type of

infection (HIV, HBV, or HIV/HBV) were not independent risk factors.

Among HIV monoinfected and HIV/HBV coinfected participants, the following

factors remained significantly associated with GFR decline:

Older age (P < 0.0001);

African origin (P = 0.0004);

Poorer baseline GFR (P < 0.0001);

Longer tenofovir duration (P = 0.007).

Other variables, including HIV transmission risk factor, CDC HIV/AIDS stage,

CD4 T-cell count, and HIV viral load were not significant risk factors.

Among people with HBV alone or HIV/HBV coinfection, significant predictors

were:

Older age (P = 0.03);

African origin (P = 0.004);

Poorer baseline GFR (P < 0.0001);

HBV viral load > 2000 IU/mL (P = 0.04).

Other variables including HBV transmission risk factor and liver fibrosis stage

were not independent predictors.

Based on these findings, the researchers concluded, " GFR decline under tenofovir

therapy appears mainly associated with older age, non-African origin, higher

baseline GFR and longer tenofovir duration. The effect of baseline HBV DNA

deserves further study. "

Investigator affiliations: Hospices Civils de Lyon, Lyon, France; INSERM U871,

Université Lyon 1, Lyon, France.

4/19/11

Reference

L Cotte, M-A Le Pogam, J-B Okon, et al. Evolution of glomerular filtration rate

in HIV-infected, HIV-HBV coinfected and HBV-infected patients receiving

tenofovir. 46th Annual Meeting of the European Association for the Study of the

Liver (EASL 2011). Berlin. March 30-April 3. Abstract 587.