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Risk Score Can Help Predict Which People Living With HIV Have Highest Risk of Kidney Disease During Tenofovir Treatment

March 31, 2014

This article was reported by NAM aidsmap.

NAM aidsmap reported on a study in which researchers developed a risk score to predict which HIV-positive persons have the highest risk of developing chronic kidney disease (CKD). There is a high risk of kidney disease if HIV remains untreated. However, certain antiretroviral drugs also are associated with high risks of kidney disease, particularly combinations with tenofovir, a drug used in first-line HIV treatment worldwide. Researchers from the U.S. Department of Veterans Affairs developed a scoring tool to predict the five-year risk of HIV-positive patients developing CKD.

The researchers reviewed records of 21,590 HIV-positive males who began treatment from 1997 to 2010 to develop the risk score. The risk score includes older age, elevated glucose, elevated systolic blood pressure, hypertension, elevated triglycerides, proteinuria, and low CD4 cell count.

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In five years of follow-up, 7.7 percent of patients treated with tenofovir developed CKD compared with 3.8 percent taking antiretrovirals without tenofovir. Also, risk scores were related to developing CKD regardless of whether the treatment contained tenofovir or not. For those taking tenofovir with a risk score of zero, there was a 1.4-percent risk within five years, increasing to 21.4 percent for those with most risk scores. The length of time on tenofovir was related to a higher five-year rate of CKD, regardless of number of risk scores.

The researchers conclude that their system allows clinicians and patients a means of determining risk of CKD and design treatment that would consider both risk and efficacy.

The full report, "A Chronic Kidney Disease Risk Score to Determine Tenofovir Safety in a Prospective Cohort of HIV-Positive Male Veterans," was published online in the journal AIDS (2014; doi:10.1097/QAD0000000000000258).

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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
 

 

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