No significant differences in nephrotoxicity for tenofovir combined with ritonavir-boosted protease inhibitors in treatment of adult HIV infection

This study retrospectively evaluated specific changes in renal parameters among HIV-infected patients treated with regimens combining tenofovir (TDF) with ritonavir-boosted protease inhibitor (PI/r) compared with non-nucleoside reverse transcriptase inhibitor (NNRTI), with non-TDF regimens, and with those on no treatment before or during the study period. Patients in the treatment groups were included if they received the same regimen continuously for at least 12 months at our medical center during 2001 to 2008. Changes from baseline creatinine clearance and glomerular filtration rate were assessed at 6 and 12 months. A total of 625 patients met our criteria: 186 on TDF+PI/r, 182 on TDF+NNRTI, 151 on non-TDF antiretroviral regimens, and 106 on no treatment. Our patients were predominantly African-American men. Declines in creatinine clearance and glomerular filtration rate were not significantly different for PI/r versus NNRTI and for any TDF versus non-TDF treatment groups at 6 or 12 months. However, there was a significant decline in creatinine clearance for the treatment when compared with no treatment groups at 12 months (p=0.008) by a multivariate general linear model adjusted for covariates. In this study, no significant differences was found in nephrotoxicity among patients receiving TDF+PI/r compared with those on TDF+NNRTI and among those receiving TDF versus non-TDF regimens for 6 and 12 months.