Renal function in Japanese HIV-1-positive patients who switch to tenofovir alafenamide fumarate after long-term tenofovir disoproxil fumarate

Abstract

\n BACKGROUND Tenofovir disoproxil fumarate (TDF) has a strong antiviral effect, but TDF is known to cause renal dysfunction. Therefore, we are investigating preventing renal dysfunction by replacing TDF with tenofovir alafenamide fumarate (TAF), which is known to be relatively safe to the kidneys. However, the changes in renal function under long-term use of TAF are not known. In this study, we evaluated renal function in Japanese HIV-1-positive patients switching to TAF after long-term treatment with TDF.METHODS A single-center observational study was conducted in Japanese HIV-1-positive patients. TDF was switched to TAF after at least 48 weeks of treatment so we could evaluate the long-term use of TDF. The primary endpoint was the estimated glomerular filtration rate (eGFR) at 144 weeks of TAF administration. In addition, we predicted the factors that would lead to changes in eGFR after long-term use of TAF.RESULTS Of the 125 HIV-1-positive patients who were prescribed TAF at our hospital during the study period, 70 fulfilled the study criteria. The eGFR at the time of switching from TDF to TAF was 81.4\u2009±\u200921.1 mL/min/1.73 m2. eGFR improved significantly after 12 weeks of taking TAF but significantly decreased at 96 and 144 weeks. At 144 weeks of taking TAF, the factors significantly correlated with the difference in eGFR from baseline were the difference in eGFR at 48 weeks of taking TAF and age at the start of TAF.CONCLUSIONS In this study, Japanese HIV-1-positive patients who had been taking TDF for a long period of time showed a decrease in eGFR after switching to long-term use of TAF. Japanese HIV-1-positive patients are expected to take TAF for a long time. Depending on age, laboratory values related to renal function need to be monitored carefully.