Pre-exposure Prophylaxis With Tenofovir Disoproxil Fumarate/Emtricitabine and Kidney Tubular Dysfunction in HIV-Uninfected Individuals

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Vasantha JotwaniMichael G Shlipak

Abstract

Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is becoming increasingly adopted for HIV prevention. Tenofovir can cause proximal tubular damage and chronic kidney disease in HIV-infected persons, but little is known regarding its nephrotoxic potential among HIV-uninfected persons. In this study, we evaluated the effects of PrEP on urine levels of the following: α1-microglobulin (α1m), a marker of impaired tubular reabsorption; albuminuria, a measure of glomerular injury; and total proteinuria. The Iniciativa Profilaxis Pre-Exposicion (iPrEx) study randomized HIV-seronegative men and transgender women who have sex with men to oral TDF/FTC or placebo. The iPrEx open-label extension (iPrEx-OLE) study enrolled former PrEP trial participants to receive open-label TDF/FTC. A cross-sectional analysis compared urine biomarker levels by study arm in iPrEx (N = 100 treatment arm, N = 100 placebo arm). Then, urine biomarker levels were compared before and after PrEP initiation in 109 participants of iPrEx-OLE. In iPrEx, there were no significant differences in urine α1m, albuminuria, or proteinuria by treatment arm. In iPrEx-OLE, after 24 weeks on PrEP, urine α1m and proteinuria increased ...Continue Reading

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Citations

May 31, 2019·The Journal of Pharmacy and Pharmacology·Pui Khee YapDinesh Kumar Chellappan
May 20, 2020·Current HIV/AIDS Reports·Matthew A SpinelliMonica Gandhi
Feb 10, 2021·Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology·Gabriela Leite BaggioPaulo Henrique Couto Souza
May 30, 2021·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Joachim H Ix, Michael G Shlipak
Jul 27, 2021·AIDS·Douglas DrakUNKNOWN Expanded PrEP Implementation in Communities New South Wales (EPIC-NSW) research group

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