Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients

Jun Won Seo; Kichun Kim; Kang Il Jun; Chang Kyung Kang; Song Mi Moon; Kyoung Ho Song; Ji Hwan Bang; Eu Suk Kim; Hong Bin Kim; Sang Won Park; Nam Joong Kim; Pyoeng Gyun Choe; Wan Beom Park; Myoung Don Oh

doi:10.3947/ic.2020.52.3.381

Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients

Jun Won Seo, Kichun Kim, Kang Il Jun, Chang Kyung Kang, Song Mi Moon, Kyoung Ho Song, Ji Hwan Bang, Eu Suk Kim, Hong Bin Kim, Sang Won Park, Nam Joong Kim, Pyoeng Gyun Choe, Wan Beom Park, Myoung Don Oh

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Background: Tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity is related to high plasma tenofovir concentrations. Tenofovir alafenamide (TAF) is a tenofovir prodrug with 90% lower plasma tenofovir concentrations. The aim of this study was to evaluate changes in tenofovir-induced nephrotoxicity in Human Immunodeficiency Virus (HIV)-positive patients who switched from TDF to TAF. Materials and Methods: We identified all HIV-positive patients who switched from elvitegravir/cobicistat/emtricitabine/TDF to elvitegravir/cobicistat/emtricitabine/TAF at a tertiary hospital. We assessed tubulopathy and renal dysfunction before TDF administration, at the time TAF was used following at least 3 months of TDF use, and 3 months after TAF administration. Tubulopathy was defined by the presence of at least three abnormalities in fractional excretion of phosphate, fractional excretion of uric acid, urinary β2-microglobulin, urinary N-acetyl-β-D-glucosaminidase, glucosuria or proteinuria. Renal dysfunction was defined as decreased by more than 25% in the estimated glomerular filtration rate (eGFR) relative to baseline. Results: In 80 patients, the mean eGFR was 96.8 mL/min/1.73 m² before administration of TDF, 81.2 (P <0.001) at the time of change to TAF, 90.9 (P <0.001) after TAF administration. Renal dysfunction occurred in 19 patients (23.8%) after TDF use for a median 15 months, 11 (57.9%) of these patients recovered from renal dysfunction after TAF administration. Six patients (7.5%) had tubulopathy before TDF administration, 36 (45.0%) after TDF administration (P <0.001), 12 (15.0%) after TAF administration (P = 0.002). Conclusion: Tenofovir-induced nephrotoxicity in HIV-positive patients receiving TDF was mostly reversible after changing to TAF. Thus, TAF-containing regimens can be administered safely to HIV-positive patients with tenofovir-induced nephrotoxicity.

Original language	English
Pages (from-to)	381-388
Number of pages	8
Journal	Infection and Chemotherapy
Volume	52
Issue number	3
DOIs	https://doi.org/10.3947/ic.2020.52.3.381
State	Published - Sep 2020

Bibliographical note

Publisher Copyright:
© 2020 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society for AIDS This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords

HIV
Renal dysfunction
Tenofovir alafenamide
Tenofovir disoproxil fumarate
Tubulopathy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3947/ic.2020.52.3.381

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Seo, J. W., Kim, K., Jun, K. I., Kang, C. K., Moon, S. M., Song, K. H., Bang, J. H., Kim, E. S., Kim, H. B., Park, S. W., Kim, N. J., Choe, P. G., Park, W. B., & Oh, M. D. (2020). Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients. Infection and Chemotherapy, 52(3), 381-388. https://doi.org/10.3947/ic.2020.52.3.381

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title = "Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients",

abstract = "Background: Tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity is related to high plasma tenofovir concentrations. Tenofovir alafenamide (TAF) is a tenofovir prodrug with 90% lower plasma tenofovir concentrations. The aim of this study was to evaluate changes in tenofovir-induced nephrotoxicity in Human Immunodeficiency Virus (HIV)-positive patients who switched from TDF to TAF. Materials and Methods: We identified all HIV-positive patients who switched from elvitegravir/cobicistat/emtricitabine/TDF to elvitegravir/cobicistat/emtricitabine/TAF at a tertiary hospital. We assessed tubulopathy and renal dysfunction before TDF administration, at the time TAF was used following at least 3 months of TDF use, and 3 months after TAF administration. Tubulopathy was defined by the presence of at least three abnormalities in fractional excretion of phosphate, fractional excretion of uric acid, urinary β2-microglobulin, urinary N-acetyl-β-D-glucosaminidase, glucosuria or proteinuria. Renal dysfunction was defined as decreased by more than 25% in the estimated glomerular filtration rate (eGFR) relative to baseline. Results: In 80 patients, the mean eGFR was 96.8 mL/min/1.73 m2 before administration of TDF, 81.2 (P <0.001) at the time of change to TAF, 90.9 (P <0.001) after TAF administration. Renal dysfunction occurred in 19 patients (23.8%) after TDF use for a median 15 months, 11 (57.9%) of these patients recovered from renal dysfunction after TAF administration. Six patients (7.5%) had tubulopathy before TDF administration, 36 (45.0%) after TDF administration (P <0.001), 12 (15.0%) after TAF administration (P = 0.002). Conclusion: Tenofovir-induced nephrotoxicity in HIV-positive patients receiving TDF was mostly reversible after changing to TAF. Thus, TAF-containing regimens can be administered safely to HIV-positive patients with tenofovir-induced nephrotoxicity.",

keywords = "HIV, Renal dysfunction, Tenofovir alafenamide, Tenofovir disoproxil fumarate, Tubulopathy",

author = "Seo, {Jun Won} and Kichun Kim and Jun, {Kang Il} and Kang, {Chang Kyung} and Moon, {Song Mi} and Song, {Kyoung Ho} and Bang, {Ji Hwan} and Kim, {Eu Suk} and Kim, {Hong Bin} and Park, {Sang Won} and Kim, {Nam Joong} and Choe, {Pyoeng Gyun} and Park, {Wan Beom} and Oh, {Myoung Don}",

note = "Publisher Copyright: {\textcopyright} 2020 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society for AIDS This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.",

year = "2020",

month = sep,

doi = "10.3947/ic.2020.52.3.381",

language = "English",

volume = "52",

pages = "381--388",

journal = "Infection and Chemotherapy",

issn = "2093-2340",

publisher = "Taehan Kamyom Hakhoe, Taehan Hwahak Yopop Hakhoe",

number = "3",

}

Seo, JW, Kim, K, Jun, KI, Kang, CK , Moon, SM , Song, KH , Bang, JH , Kim, ES , Kim, HB , Park, SW , Kim, NJ , Choe, PG , Park, WB & Oh, MD 2020, 'Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients', Infection and Chemotherapy, vol. 52, no. 3, pp. 381-388. https://doi.org/10.3947/ic.2020.52.3.381

TY - JOUR

T1 - Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients

AU - Seo, Jun Won

AU - Kim, Kichun

AU - Jun, Kang Il

AU - Kang, Chang Kyung

AU - Moon, Song Mi

AU - Song, Kyoung Ho

AU - Bang, Ji Hwan

AU - Kim, Eu Suk

AU - Kim, Hong Bin

AU - Park, Sang Won

AU - Kim, Nam Joong

AU - Choe, Pyoeng Gyun

AU - Park, Wan Beom

AU - Oh, Myoung Don

N1 - Publisher Copyright: © 2020 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society for AIDS This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

PY - 2020/9

Y1 - 2020/9

N2 - Background: Tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity is related to high plasma tenofovir concentrations. Tenofovir alafenamide (TAF) is a tenofovir prodrug with 90% lower plasma tenofovir concentrations. The aim of this study was to evaluate changes in tenofovir-induced nephrotoxicity in Human Immunodeficiency Virus (HIV)-positive patients who switched from TDF to TAF. Materials and Methods: We identified all HIV-positive patients who switched from elvitegravir/cobicistat/emtricitabine/TDF to elvitegravir/cobicistat/emtricitabine/TAF at a tertiary hospital. We assessed tubulopathy and renal dysfunction before TDF administration, at the time TAF was used following at least 3 months of TDF use, and 3 months after TAF administration. Tubulopathy was defined by the presence of at least three abnormalities in fractional excretion of phosphate, fractional excretion of uric acid, urinary β2-microglobulin, urinary N-acetyl-β-D-glucosaminidase, glucosuria or proteinuria. Renal dysfunction was defined as decreased by more than 25% in the estimated glomerular filtration rate (eGFR) relative to baseline. Results: In 80 patients, the mean eGFR was 96.8 mL/min/1.73 m2 before administration of TDF, 81.2 (P <0.001) at the time of change to TAF, 90.9 (P <0.001) after TAF administration. Renal dysfunction occurred in 19 patients (23.8%) after TDF use for a median 15 months, 11 (57.9%) of these patients recovered from renal dysfunction after TAF administration. Six patients (7.5%) had tubulopathy before TDF administration, 36 (45.0%) after TDF administration (P <0.001), 12 (15.0%) after TAF administration (P = 0.002). Conclusion: Tenofovir-induced nephrotoxicity in HIV-positive patients receiving TDF was mostly reversible after changing to TAF. Thus, TAF-containing regimens can be administered safely to HIV-positive patients with tenofovir-induced nephrotoxicity.

AB - Background: Tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity is related to high plasma tenofovir concentrations. Tenofovir alafenamide (TAF) is a tenofovir prodrug with 90% lower plasma tenofovir concentrations. The aim of this study was to evaluate changes in tenofovir-induced nephrotoxicity in Human Immunodeficiency Virus (HIV)-positive patients who switched from TDF to TAF. Materials and Methods: We identified all HIV-positive patients who switched from elvitegravir/cobicistat/emtricitabine/TDF to elvitegravir/cobicistat/emtricitabine/TAF at a tertiary hospital. We assessed tubulopathy and renal dysfunction before TDF administration, at the time TAF was used following at least 3 months of TDF use, and 3 months after TAF administration. Tubulopathy was defined by the presence of at least three abnormalities in fractional excretion of phosphate, fractional excretion of uric acid, urinary β2-microglobulin, urinary N-acetyl-β-D-glucosaminidase, glucosuria or proteinuria. Renal dysfunction was defined as decreased by more than 25% in the estimated glomerular filtration rate (eGFR) relative to baseline. Results: In 80 patients, the mean eGFR was 96.8 mL/min/1.73 m2 before administration of TDF, 81.2 (P <0.001) at the time of change to TAF, 90.9 (P <0.001) after TAF administration. Renal dysfunction occurred in 19 patients (23.8%) after TDF use for a median 15 months, 11 (57.9%) of these patients recovered from renal dysfunction after TAF administration. Six patients (7.5%) had tubulopathy before TDF administration, 36 (45.0%) after TDF administration (P <0.001), 12 (15.0%) after TAF administration (P = 0.002). Conclusion: Tenofovir-induced nephrotoxicity in HIV-positive patients receiving TDF was mostly reversible after changing to TAF. Thus, TAF-containing regimens can be administered safely to HIV-positive patients with tenofovir-induced nephrotoxicity.

KW - HIV

KW - Renal dysfunction

KW - Tenofovir alafenamide

KW - Tenofovir disoproxil fumarate

KW - Tubulopathy

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U2 - 10.3947/ic.2020.52.3.381

DO - 10.3947/ic.2020.52.3.381

M3 - Article

AN - SCOPUS:85095437486

SN - 2093-2340

VL - 52

SP - 381

EP - 388

JO - Infection and Chemotherapy

JF - Infection and Chemotherapy

IS - 3

ER -

Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients

Abstract

Bibliographical note

Keywords

UN SDGs

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