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

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

Fingerprint

Anti-HIV Agents
Protease Inhibitors
Chronic Renal Insufficiency
HIV
Ritonavir
Incidence
Confidence Intervals
Atazanavir Sulfate
Darunavir

Keywords

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

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

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

In: Journal of Infectious Diseases, Vol. 220, No. 10, 08.10.2019, p. 1629-1634.

Research output: Contribution to journalArticle

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, vol. 220, no. 10, pp. 1629-1634. https://doi.org/10.1093/infdis/jiz369
Ryom, Lene ; Dilling Lundgren, Jens ; Reiss, Peter ; Kirk, Ole ; Law, Matthew ; Ross, Mike ; Morlat, Phillip ; Andreas Fux, Christoph ; Fontas, Eric ; De Wit, Stephane ; D'Arminio Monforte, Antonella ; El-Sadr, Wafaa ; Phillips, Andrew ; Ingrid Hatleberg, Camilla ; Sabin, Caroline ; Mocroft, Amanda. / 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. In: Journal of Infectious Diseases. 2019 ; Vol. 220, No. 10. pp. 1629-1634.
@article{675ea52c5f114ea0917dc02814cb265c,
title = "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",
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.",
keywords = "adverse drug effect, atazanavir, CKD, darunavir, HIV, nephrotoxicity, protease inhibitors",
author = "Lene Ryom and {Dilling Lundgren}, Jens and Peter Reiss and Ole Kirk and Matthew Law and Mike Ross and Phillip Morlat and {Andreas Fux}, Christoph and Eric Fontas and {De Wit}, Stephane and {D'Arminio Monforte}, Antonella and Wafaa El-Sadr and Andrew Phillips and {Ingrid Hatleberg}, Camilla and Caroline Sabin and Amanda Mocroft",
year = "2019",
month = "10",
day = "8",
doi = "10.1093/infdis/jiz369",
language = "English (US)",
volume = "220",
pages = "1629--1634",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "10",

}

TY - JOUR

T1 - Use of Contemporary Protease Inhibitors and Risk of Incident Chronic Kidney Disease in Persons with Human Immunodeficiency Virus

T2 - The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study

AU - Ryom, Lene

AU - Dilling Lundgren, Jens

AU - Reiss, Peter

AU - Kirk, Ole

AU - Law, Matthew

AU - Ross, Mike

AU - Morlat, Phillip

AU - Andreas Fux, Christoph

AU - Fontas, Eric

AU - De Wit, Stephane

AU - D'Arminio Monforte, Antonella

AU - El-Sadr, Wafaa

AU - Phillips, Andrew

AU - Ingrid Hatleberg, Camilla

AU - Sabin, Caroline

AU - Mocroft, Amanda

PY - 2019/10/8

Y1 - 2019/10/8

N2 - 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.

AB - 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.

KW - adverse drug effect

KW - atazanavir

KW - CKD

KW - darunavir

KW - HIV

KW - nephrotoxicity

KW - protease inhibitors

UR - http://www.scopus.com/inward/record.url?scp=85073088603&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073088603&partnerID=8YFLogxK

U2 - 10.1093/infdis/jiz369

DO - 10.1093/infdis/jiz369

M3 - Article

C2 - 31504669

AN - SCOPUS:85073088603

VL - 220

SP - 1629

EP - 1634

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 10

ER -