OBJECTIVES The risk of kidney dysfunction on the WHO recommended first line regimens containing tenofovir disoproxil fumarate (TDF) without protease inhibitors (PI) remains unclear in Asian patients, especially those with low body weight. METHODS Using data collected in a multicenter clinical trial in Thailand and proportional hazard regression models, we compared the risk of a >25% estimated glomerular filtration rate (eGFR) reduction in HIV naïve patients initiating TDF or zidovudine (AZT) containing non-PI regimen. RESULTS Of 640 patients included in the analysis, 461 (72%) received a TDF-containing regimen for a median 6.7 years and 179 (28%) an AZT-containing regimen for 6.5 years. The risk of a >25% eGFR reduction was not associated with treatment (HR 1.11, 95% CI 0.84-1.47, P = 0.46). In multivariate analysis, the risk of >25% eGFR reduction form baseline was associated with body weight at baseline (HR 2.12, 95% CI 1.48-3.02 for <48 kg patients and HR 1.64, 95% CI 1.20-2.25 for 48-59.9 kg patients, compared to those with >60 kg, P < 0.001) and hypertension (HR 4.03, 95% CI 2.0-8.0, P < 0.001). The effect of baseline weight on >25% eGFR reduction did not significantly vary with treatment (P = 0.27). CONCLUSIONS The risk of eGFR reduction was not higher on TDF- versus AZT-based non-PI regimens. Although the risk of eGFR reduction was greater for patients of lower body weight, this risk was not significantly increased by TDF.

中文翻译：

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接受替诺福韦酯富马酸富马酸无蛋白酶抑制剂的亚洲HIV-1感染成年人的长期肾功能。

目的对于亚洲患者，尤其是体重低的患者，尚不清楚世界卫生组织推荐的一线治疗方案中含有替诺福韦富马酸替诺福韦酯（TDF）而无蛋白酶抑制剂（PI）的肾功能不全的风险。方法使用泰国多中心临床试验中收集的数据和比例风险回归模型，我们比较了初次使用非PI方案的TDF或齐多夫定（AZT）的HIV初治患者肾小球滤过率（eGFR）降低> 25％的风险。结果分析的640名患者中，有461名（72％）接受了含TDF方案，中位治疗期为6.7年，有179名（28％）接受了AZT方案，接受了6.5年。eGFR降低> 25％的风险与治疗无关（HR 1.11，95％CI 0.84-1.47，P = 0.46）。在多变量分析中，> 基线时eGFR降低25％与基线体重相关（<48 kg患者的HR 2.12，95％CI 1.48-3.02，48-59.9 kg患者的HR 1.64，95％CI 1.20-2.25，而>> 60公斤，P <0.001）和高血压（HR 4.03，95％CI 2.0-8.0，P <0.001）。基线体重对eGFR降低> 25％的影响随治疗而无显着变化（P = 0.27）。结论与基于AZT的非PI方案相比，基于TDF的eGFR降低的风险并不更高。尽管体重减轻的患者eGFR降低的风险更大，但TDF并没有显着增加这种风险。001）和高血压（HR 4.03，95％CI 2.0-8.0，P <0.001）。基线体重对eGFR降低> 25％的影响随治疗而无显着变化（P = 0.27）。结论与基于AZT的非PI方案相比，基于TDF的eGFR降低的风险并不更高。尽管体重减轻的患者eGFR降低的风险更大，但TDF并没有显着增加这种风险。001）和高血压（HR 4.03，95％CI 2.0-8.0，P <0.001）。基线体重对eGFR降低> 25％的影响随治疗而无显着变化（P = 0.27）。结论与基于AZT的非PI方案相比，基于TDF的eGFR降低的风险并不更高。尽管体重减轻的患者eGFR降低的风险更大，但TDF并没有显着增加这种风险。