Mulubwa Mwila, Rheeders Malie, Fourie Carla, Viljoen Michelle
Centre of Excellence for Pharmaceutical Sciences (Pharmacen), Division of Pharmacology, North-West University, South Africa.
Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Science, North-West University, South Africa.
South Afr J HIV Med. 2016 Jul 28;17(1):458. doi: 10.4102/sajhivmed.v17i1.458. eCollection 2016.
Tenofovir disoproxil fumarate (TDF) has been associated with kidney tubular dysfunction and reduced renal function. Limited studies were performed in Europe and Asia that related plasma tenofovir (TFV) concentration with renal function; no such studies to date have been performed on Africans.
To investigate the correlation between plasma tenofovir (TFV) concentration and certain renal function markers in HIV-infected women on TDF antiretroviral therapy (ART). These markers were also compared to a HIV-uninfected control group.
HIV-infected women ( = 30) on TDF-based ART were matched with 30 controls for age and body mass index. Renal markers analysed were estimated glomerular filtration rate (eGFR), creatinine clearance (CrCl), serum creatinine, albuminuria, glucosuria, serum urea, serum uric acid, urine sodium and maximum tubular reabsorption of phosphate. Baseline eGFR and CrCl data were obtained retrospectively for the HIV-infected women. Plasma TFV was assayed using a validated HPLC-MS/MS method. Stepwise regression, Mann-Whitney test, unpaired and paired -tests were applied in the statistical analyses.
TFV concentration was independently associated with albuminuria (adjusted = 0.339 = 0.001) in HIV-infected women. In the adjusted (weight) analysis, eGFR ( = 0.038), CrCl ( = 0.032) and albuminuria ( = 0.048) were significantly higher in HIV-infected compared to the uninfected women, but eGFR was abnormally high in HIV-infected women. Both eGFR ( < 0.001) and CrCl ( = 0.008) increased from baseline to follow-up in HIV-infected women.
Plasma TFV concentration was associated with increased albuminuria in HIV-infected women in this sub-study. Both eGFR and CrCl were increased in HIV-infected women from baseline. These findings should be confirmed in larger studies, and hyperfiltration in HIV-infected women warrants further investigation.
富马酸替诺福韦二吡呋酯（TDF）与肾小管功能障碍及肾功能降低有关。在欧洲和亚洲开展的关于血浆替诺福韦（TFV）浓度与肾功能关系的研究有限；迄今为止尚未对非洲人进行此类研究。
探讨接受TDF抗逆转录病毒疗法（ART）的HIV感染女性血浆替诺福韦（TFV）浓度与某些肾功能标志物之间的相关性。还将这些标志物与未感染HIV的对照组进行比较。
将30名接受基于TDF的ART的HIV感染女性与30名年龄和体重指数相匹配的对照者进行配对。分析的肾脏标志物包括估计肾小球滤过率（eGFR）、肌酐清除率（CrCl）、血清肌酐、蛋白尿、糖尿、血清尿素、血清尿酸、尿钠以及磷酸盐最大肾小管重吸收。回顾性获取HIV感染女性的基线eGFR和CrCl数据。采用经过验证的HPLC-MS/MS方法检测血浆TFV。在统计分析中应用逐步回归、曼-惠特尼检验、非配对和配对t检验。
在HIV感染女性中，TFV浓度与蛋白尿独立相关（校正β = 0.339，P = 0.001）。在校正（权重）分析中，与未感染女性相比，HIV感染女性的eGFR（P = 0.038）、CrCl（P = 0.032）和蛋白尿（P = 0.048）显著更高，但HIV感染女性的eGFR异常高。HIV感染女性从基线到随访期间eGFR（P < 0.001）和CrCl（P = 0.008）均升高。
在本亚组研究中，HIV感染女性的血浆TFV浓度与蛋白尿增加有关。HIV感染女性的eGFR和CrCl均较基线升高。这些发现应在更大规模研究中得到证实，且HIV感染女性的超滤现象值得进一步研究。
