Original Research

Associations between plasma tenofovir concentration and renal function markers in HIV-infected women

Mwila Mulubwa, Malie Rheeders, Carla Fourie, Michelle Viljoen
Southern African Journal of HIV Medicine | Vol 17, No 1 | a458 | DOI: https://doi.org/10.4102/sajhivmed.v17i1.458 | © 2016 Mwila Mulubwa, Malie Rheeders, Carla Fourie, Michelle Viljoen | This work is licensed under CC Attribution 4.0
Submitted: 14 January 2016 | Published: 28 July 2016

About the author(s)

Mwila Mulubwa, Centre of Excellence for Pharmaceutical Sciences (Pharmacen), Division of Pharmacology, North-West University, South Africa
Malie Rheeders, Centre of Excellence for Pharmaceutical Sciences (Pharmacen), Division of Pharmacology, North-West University, South Africa
Carla Fourie, Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Science, North-West University, South Africa
Michelle Viljoen, Centre of Excellence for Pharmaceutical Sciences (Pharmacen), Division of Pharmacology, North-West University, South Africa


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Abstract

Background: Tenofovir disoproxil fumarate (TDF) has been associated with kidney tubulardys function and reduced renal function. Limited studies were performed in Europe and Asia that related plasma tenofovir (TFV) concentration with renal function; no such studies to date have been performed on Africans.

Objective: To investigate the correlation between plasma tenofovir (TFV) concentration and certain renal function markers in HIV-infected women on TDF antiretroviral therapy (ART).These markers were also compared to a HIV-uninfected control group.

Methods: HIV-infected women (n = 30) on TDF-based ART were matched with 30 controls forage and body mass index. Renal markers analysed were estimated glomerular filtration rate (eGFR), creatinine clearance (CrCl), serum creatinine, albuminuria, glucosuria, serum urea, serum uric acid, urine sodium and maximum tubular reabsorption of phosphate. Baseline eGFR and CrCl data were obtained retrospectively for the HIV-infected women. Plasma TFV was assayed using a validated HPLC-MS/MS method. Step wise regression, Mann–Whitney test, unpaired and paired t-tests were applied in the statistical analyses.

Results: TFV concentration was independently associated with albuminuria (adjusted r2 = 0.339; p = 0.001) in HIV-infected women. In the adjusted (weight) analysis, eGFR (p = 0.038),CrCl (p = 0.032) and albuminuria (p = 0.048) were significantly higher in HIV-infected compared to the uninfected women, but eGFR was abnormally high in HIV-infected women. Both eGFR (p < 0.001) and CrCl (p = 0.008) increased from baseline to follow-up in HIV-infected women.

Conclusion: Plasma TFV concentration was associated with increased albuminuria in HIV infected women in this sub-study. Both eGFR and CrCl were increased in HIV-infected women from baseline. These findings should be confirmed in larger studies, and hyperfiltration in HIV-infected women warrants further investigation.


Keywords

Tenofovir; renal dysfunction, albuminuria

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