Renal health after long-term exposure to tenofovir disoproxil fumarate (TDF) in HIV/HBV positive adults in Ghana

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dc.contributor.authorPhillips, Richard Odame
dc.contributor.authorVilla, G.
dc.contributor.authorSmith, C.
dc.contributor.authorStockdale, A.J.
dc.contributor.authorBeloukas, A.
dc.contributor.authoret. al
dc.date.accessioned2020-01-13T12:40:14Z
dc.date.accessioned2023-04-19T01:47:45Z
dc.date.available2020-01-13T12:40:14Z
dc.date.available2023-04-19T01:47:45Z
dc.date.issued2018
dc.descriptionAn article published by ElsevierLtden_US
dc.description.abstractObjectives: The study assessed markers of renal health in HIV/HBV co-infected patients receiving TDF- containing antiretroviral therapy in Ghana. Methods: Urinary protein-to-creatinine ratio (uPCR) and albumin-to-protein ratio (uAPR) were measured cross-sectionally after a median of four years of TDF. At this time, alongside extensive laboratory testing, patients underwent evaluation of liver stiffness and blood pressure. The estimated glomerular filtration rate (eGFR) was measured longitudinally before and during TDF therapy. Results: Among 101 participants (66% women, median age 44 years, median CD4 count 572 cells/mm 3 ) 21% and 17% had detectable HIV-1 RNA and HBV DNA, respectively. Overall 35% showed hypertension, 6% diabetes, 7% liver stiffness indicative of cirrhosis, and 18% urinary excretion of Schistosoma antigen. Tubular proteinuria occurred in 16% of patients and was independently predicted by female gender and hypertension. The eGFR declined by median 1.8 ml/min/year during TDF exposure (IQR −4.4, −0.0); more pronounced declines ( ≥5 ml/min/year) occurred in 22% of patients and were associated with receiv- ing ritonavir-boosted lopinavir rather than efavirenz. HBV DNA, HBeAg, transaminases, and liver stiffness were not predictive of renal function abnormalities. Conclusions: The findings mandate improved diagnosis and management of hypertension and suggest targeted laboratory monitoring of patients receiving TDF alongside a booster in sub-Saharan Africa.en_US
dc.description.sponsorshipKNUSTen_US
dc.identifier.citationElsevierLtd Journal of Infection 76 (2018) 515–521en_US
dc.identifier.urihttps://ir.knust.edu.gh/handle/123456789/11921
dc.language.isoenen_US
dc.publisherElsevierLtden_US
dc.subjectTenofoviren_US
dc.subjectKidneyen_US
dc.subjectBoosteren_US
dc.subjectHypertensionen_US
dc.subjectHBVen_US
dc.titleRenal health after long-term exposure to tenofovir disoproxil fumarate (TDF) in HIV/HBV positive adults in Ghanaen_US
dc.typeArticleen_US
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