Dr. Hardik P Patel, Dr. Shubham Kumar, Dr. Deepashree Talaulikar


OBJECTIVE: Tenofovir disoproxil fumarate (TDF) is a nucleotide analogue recommended in international HIV
treatment guidelines. Purpose of this study was to estimate the long term effects of TDF on renal prole in a cohort of HIV
patients in Goa. Three hundred and fty four (354) consecutive HIV-positive patients who initiated TDF-based antiretroviral treatment from Jan
2016 to Dec 2018 at the Goa Medical College were sampled. Creatinine clearance (CrCl) was calculated using the Cockcroft-Gault equation at
baseline and renal impairment was dened as CrCl values of 30.0–49.9 mL/min (moderate renal impairment) and < 25 mL/min (severe renal
impairment) as per institutional guidelines for renal function test.
RESULTS: Follow up time was 2 years. At study endpoint, 36 participants (10.2%) recorded CrCl rate below 50 mL/min indicating incident renal
impairment, made up of 8.47% moderate renal impairment and 1.7% severe renal impairment. Factors associated with incidence of renal
impairment were increasing age, WHO HIV stage III/IV and baseline low CD4 count. Patients with identied renal impairment risk factors at
ART initiation should be targeted and monitored effectively to prevent renal injury.

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