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dc.contributor.authorNinutcha Paengsaien_US
dc.contributor.authorKajohnsak Noppakunen_US
dc.contributor.authorGonzague Jourdainen_US
dc.contributor.authorTim Roy Cresseyen_US
dc.contributor.authorNicolas Salvadorien_US
dc.contributor.authorRomanee Chaiwarithen_US
dc.contributor.authorApichat Tantraworasinen_US
dc.contributor.authorJean Yves Maryen_US
dc.contributor.authorChureeratana Bowonwatanuwongen_US
dc.contributor.authorSorakij Bhakeecheepen_US
dc.contributor.authorPatrinee Traisathiten_US
dc.contributor.authorNatapong Kosachunhanunen_US
dc.description.abstractTenofovir disoproxil fumarate (TDF) is associated with a risk of chronic kidney disease (CKD), especially in Asian populations. Data from the Thai national health insurance system was used to assess CKD incidence in patients receiving antiretroviral therapy in real-world practice. We analyzed data from patients who initiated one of the following first-line regimens: zidovudine + lamivudine + nevirapine (AZT + 3TC + NVP); zidovudine + lamivudine + efavirenz (AZT + 3TC + EFV); tenofovir + lamivudine + nevirapine (TDF + 3TC + NVP); tenofovir + lamivudine/emtricitabine + efavirenz (TDF + 3TC/FTC + EFV); and tenofovir +lamivudine +lopinavir/ritonavir (TDF + 3TC + LPV/r). CKD was defined as glomerular filtration rate <60 mL/min/1.73 m2 for >3 months, or a confirmed 2010 WHO diagnosis (ICD-10 code N183, N184, or N185). Death competing risk survival regression models were used. Among 27,313 participants, with a median age of 36.8 years and median follow-up of 2.3 years, 245 patients (0.9%) were diagnosed with CKD (incidence 3.2 per 1000 patient-years; 95% CI 2.8–3.6). Compared with patients receiving AZT + 3TC + NVP, the risk of CKD measured by adjusted sub-distribution hazard ratio (aSHR) was 6.5 (95% CI 3.9–11.1) in patients on TDF + 3TC + LPV/r, 3.8 (95% CI 2.3–6.0) in TDF + 3TC + NVP, and 1.6 (95% CI 1.2–2.3) in TDF + 3TC/FTC + EFV. Among patients receiving TDF, compared with those receiving TDF + 3TC/FTC + EFV, the aSHR was 4.0 (95% CI 2.3–6.8) in TDF + 3TC + LPV/r and 2.3 (95% CI 1.4–3.6) in TDF + 3TC + NVP. TDF was associated with an increased risk of CKD, especially when combined with LPV/r or NVP.en_US
dc.subjectHealth Professionsen_US
dc.titleChronic Kidney Disease in a Large National Human Immunodeficiency Virus Treatment Programen_US
article.title.sourcetitleHealthcare (Switzerland)en_US
article.volume10en_US of Phayaoen_US Health Security Officeen_US of Medicine, Chiang Mai Universityen_US Regional Hospitalen_US Institut de Recherche pour le Developpementen_US of Liverpoolen_US Mai Universityen_US
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