从富马酸替诺福韦二吡呋酯转换为替诺福韦艾拉酚胺对 HIV 患者估计肾小球滤过率斜率的影响：一项回顾性观察研究。

Effect of switching from tenofovir disoproxil fumarate to tenofovir alafenamide on estimated glomerular filtration rate slope in patients with HIV: A retrospective observational study.

机构信息

Department of Pharmacy, Hyogo College of Medicine College Hospital, Address: 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.

出版信息

J Infect Chemother. 2022 Mar;28(3):396-400. doi: 10.1016/j.jiac.2021.11.016. Epub 2021 Dec 9.

DOI:10.1016/j.jiac.2021.11.016

PMID:34896027

Abstract

INTRODUCTION

There is limited data on the effects of switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) on estimated glomerular filtration rates (eGFR) slope in patients with human immunodeficiency virus (HIV) infection. This study aimed to compare the eGFR slope when administering TDF and TAF and to investigate the predictors of improvement in eGFR slope after switching from TDF to TAF.

METHODS

We conducted a single-center, retrospective, observational study in Japanese patients with HIV infection who switched the antiretroviral drug from TDF to TAF. eGFR was calculated using serum cystatin C. The eGFR slope was defined as the regression coefficient between eGFR and time. Differences between eGFR slope during TDF and TAF administration were compared using Wilcoxon signed rank test. A stepwise logistic regression model was used to examine the associations between improvement of eGFR slope after switching from TDF to TAF and various parameters.

RESULTS

Overall, 63 patients (656 eGFR) were included in the analysis. The median analyzed durations of TDF and TAF exposures were 1.6 and 1.5 years, respectively. There were no significant differences between eGFR slope during TDF and TAF periods (median: 0.6 vs. 4.0 mL/min/1.73 m/year, p = 0.165). The eGFR slopes during the TDF period and while switching from TDF to TAF were independent predictors of improvement in eGFR slope after switching from TDF to TAF.

CONCLUSIONS

The results suggest that patients with poor renal function and those with progressive worsening during TDF administration would benefit from switching to TAF.

摘要

简介

在人类免疫缺陷病毒（HIV）感染患者中，将替诺福韦二吡呋酯（TDF）转换为替诺福韦艾拉酚胺（TAF）对估计肾小球滤过率（eGFR）斜率的影响数据有限。本研究旨在比较 TDF 和 TAF 给药时的 eGFR 斜率，并探讨从 TDF 转换为 TAF 后 eGFR 斜率改善的预测因素。

方法

我们在日本 HIV 感染患者中进行了一项单中心、回顾性、观察性研究，这些患者将抗逆转录病毒药物从 TDF 转换为 TAF。使用血清胱抑素 C 计算 eGFR。eGFR 斜率定义为 eGFR 与时间之间的回归系数。使用 Wilcoxon 符号秩检验比较 TDF 和 TAF 给药期间 eGFR 斜率的差异。使用逐步逻辑回归模型检查从 TDF 转换为 TAF 后 eGFR 斜率改善与各种参数之间的关联。

结果

总体而言，分析中包括 63 名患者（656 个 eGFR）。TDF 和 TAF 暴露的中位分析时间分别为 1.6 年和 1.5 年。TDF 和 TAF 期间的 eGFR 斜率无显著差异（中位数：0.6 与 4.0 mL/min/1.73 m/年，p = 0.165）。TDF 期间的 eGFR 斜率和从 TDF 转换为 TAF 期间的 eGFR 斜率是从 TDF 转换为 TAF 后 eGFR 斜率改善的独立预测因素。