부산대학교 도서관

Background: Whereas tenofovir disoproxil fumarate (TDF) can lead to renal adverse events, tenofovir alafenamide (TAF) has a more favorable renal safety profile. However, the impact of replacing TDF with TAF on renal function and liver parameters among HIV/hepatitis B virus (HBV)- coinfected individuals with renal dysfunction remains unclear. Methods: We included all participants from the Swiss HIV Cohort Study with an HIV/HBV coinfection who switched from TDF to TAF and had an estimated glomerular filtration rate (eGFR) ,90 mL/min/1.73 m2 and a suppressed HIV viral load (,200 cp/mL). We assessed changes in eGFR, urine protein-to-creatinine ratio, and alanine aminotransferase (ALT) after 1 year using mixed-effect models with interrupted time series. Results: Among 106 participants (15.1% women, median age 53 years), eGFR was 60-89 mL/min/1.73 m2 in 84 (79.2%) and ,60 mL/min/1.73 m2 in 22 (20.8%) individuals at the time of switch. One year after the switch from TDF to TAF, individuals with an eGFR between 60 and 89 mL/min/1.73 m2 experienced increases in eGFR of 3.2 mL/min/1.73 m2 (95% confidence interval [CI] 1.2 to 5.2), whereas those with an eGFR ,60 mL/min/1.73 m2 experienced improvements of 6.2 mL/min/1.73 m2 (95% CI 2.4 to 10.0). Urine protein-to-creatinine ratio decreased overall (26.3 mg/mmol, 95% CI 210.0 to 22.7), and ALT levels declined in patients with elevated baseline levels (211.8 IU/L, 95% CI 217.3 to 26.4) 1 year after replacing TDF with TAF. Conclusions: Switching from TDF to TAF among HIV/HBVcoinfected individuals with renal impairment led to improvements in eGFR, a decline in proteinuria, and to ALT normalization in those with elevated ALT levels. [ABSTRACT FROM AUTHOR]