Evaluation of Kidney Function Tests in HIV-Positive Patients Receiving
Combined Antiretroviral Therapy
Abstract
Introduction: Human Immunodeficiency virus is a chronic infection that
attacks the immune system of the human body, particularly CD4 T
lymphocytes. Combined antiretroviral therapies are highly effective in
virological suppression of human immunodeficiency virus infection. It
has been shown that some retroviral therapies have a higher
nephrotoxicity potential. As a result of renal injury, serum creatinine
increases, and the estimated glomerular filtration rate is reduced. The
aim of our study was to assess changes in kidney function during a
24-month period in HIV-positive patients who were begun on combined
antiretroviral therapy. Material-method: A total of 127 HIV positive
patients were enrolled. The patients were divided into five groups;
patients who received no therapy were designated as Group 1; those that
received Dolutegravir/Abacavir/Lamivudine combination as Group 2; those
that received Elvitegravir/Cobicistat/Emtricitabine/Tenofovir
Alafenamide Fumarate combination as Group 3; those that received
Emtricitabine/Tenofovir Disoproxil Fumarate/Dolutegravir combination as
Group 4; and those that received Emtricitabine/Tenofovir Disoproxil
Fumarate/Raltegravir combination as Group 5. We compared the effects of
these drugs on estimated glomerular filtration rate during a 24-month
follow-up period. Results: At the 24th month of therapy, a significant
difference was observed between the eGFR levels of the study groups
(p:<0.001). eGFR level was significantly higher in Group 4
compared to Groups 1, 2, and 3 (p:0.009, p:<0.001,
p:<0.001, respectively) while it was significantly lower in
Group 5 than groups 1, 2, and 3 (p:0.005, p:<0.001,
p:<0.001, respectively). No significant eGFR difference was
found between Group 4 and Group 5 (p>0.05). Serum
creatinine level was significantly higher in Groups 4 and 5 compared to
the other groups (p<0.001). Conclusion: The use of
TDF-containing regimens causes renal dysfunction. Therefore, we
recommend close monitoring of renal function, especially in patients
treated with TDF.