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Báo cáo y học: "Renal impairment after switching from stavudine/ lamivudine to tenofovir/lamivudine in NNRTIbased antiretroviral regimens"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Renal impairment after switching from stavudine/ lamivudine to tenofovir/lamivudine in NNRTIbased antiretroviral regimens. | Manosuthi et al. AIDS Research and Therapy 2010 7 37 http www.aidsrestherapy.eom content 7 1 37 AIDS RESEARCH AND THERAPY RESEARCH Open Access Renal impairment after switching from stavudine lamivudine to tenofovir lamivudine in NNRTI-based antiretroviral regimens 1.2 1 111 Weerawat Manosuthi Wiroj Mankatitham Aroon Lueangniyomkul Wisit Prasithsirikul Preecha Tantanathip Busakorn Suntisuklappon1 Anongnuch Narkksoksung1 Samruay Nilkamhang1 Somnuek Sungkanuparph2 Abstract Background During stavudine phase-out plan in developing countries tenofovir is used to substitute stavudine. However knowledge regarding whether there is any difference of the frequency of renal injury between tenofovir lamivudine efavirenz and tenofovir lamivudine nevirapine is lacking. Methods This prospective study was conducted among HIV-infected patients who were switched NRTI from stavudine lamivudine to tenofovir lamivudine in efavirenz-based EFV group and nevirapine-based regimen NVP group after two years of an ongoing randomized trial. All patients were assessed for serum phosphorus uric acid creatinine estimated glomerular filtration rate eGFR and urinalysis at time of switching 12 and 24 weeks. Results Of 62 patients 28 were in EFV group and 34 were in NVP group. Baseline characteristics and eGFR were not different between two groups. At 12 weeks comparing mean SD measures between EFV group and NVP group were phosphorus of 3.16 0.53 vs. 2.81 0.42 mg dL P 0.005 patients with proteinuria were 15 vs. 38 P 0.050 . At 24 weeks mean SD phosphorus and median IQR eGFR between the corresponding groups were 3.26 0.78 vs. 2.84 0.47 mg dL P 0.011 and 110 99-121 vs. 98 83-112 mL min P 0.008 . In NVP group comparing week 12 to time of switching there was a decrement of phosphorus P 0.007 and eGFR P 0.034 . By multivariate analysis receiving nevirapine old age and low baseline serum phosphorus were associated with hypophosphatemia at 24 weeks P 0.05 . Receiving nevirapine and low baseline eGFR were .