Use of Contemporary Protease Inhibitors and Risk of Incident Chronic Kidney Disease in Persons with Human Immunodeficiency Virus: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study

Lene Ryom, Jens Dilling Lundgren, Peter Reiss, Ole Kirk, Matthew Law, Mike Ross, Phillip Morlat, Christoph Andreas Fux, Eric Fontas, Stephane De Wit, Antonella D'Arminio Monforte, Wafaa El-Sadr, Andrew Phillips, Camilla Ingrid Hatleberg, Caroline Sabin, Amanda Mocroft

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors. Methods: Participants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last visit plus 6 months, or 1 February 2016. Adjusted Poisson regression was used to assess associations between CKD and the use of ritonavir-boosted atazanavir (ATV/r) or ritonavir-boosted darunavir (DRV/r). Results: The incidence of CKD (10.0/1000 person-years of follow-up; 95% confidence interval, 9.5-10.4/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r, but the relation was less clear for DRV/r. After adjustment, only exposure to ATV/r (adjusted incidence rate ratio, 1.4; 95% confidence interval, 1.2-1.6), but not exposure to DRV/r (1.0;. 8-1.3), remained significantly associated with CKD. Conclusion: While DRV/r use was not significantly associated with CKD an increasing incidence with longer ATV/r use was confirmed.

Original languageEnglish (US)
Pages (from-to)1629-1634
Number of pages6
JournalJournal of Infectious Diseases
Volume220
Issue number10
DOIs
StatePublished - Oct 8 2019

Keywords

  • CKD
  • HIV
  • adverse drug effect
  • atazanavir
  • darunavir
  • nephrotoxicity
  • protease inhibitors

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Ryom, L., Dilling Lundgren, J., Reiss, P., Kirk, O., Law, M., Ross, M., Morlat, P., Andreas Fux, C., Fontas, E., De Wit, S., D'Arminio Monforte, A., El-Sadr, W., Phillips, A., Ingrid Hatleberg, C., Sabin, C., & Mocroft, A. (2019). Use of Contemporary Protease Inhibitors and Risk of Incident Chronic Kidney Disease in Persons with Human Immunodeficiency Virus: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study. Journal of Infectious Diseases, 220(10), 1629-1634. https://doi.org/10.1093/infdis/jiz369