HIV positive patients on HAART continue to have a decline in renal function irrespective of Tenofovir usage: A 2-year cohort from an Indian tertiary care centre

ABSTRACT Context HIV patients may undergo renal damage due to disease or nephrotoxic drugs. Tenofovir has been associated with the development of renal impairment. Aims To study and compare trends in Creatinine Clearance (CrCl) and estimated Glomerular Filtration Rate (eGFR) in patients on Highly Active Antiretroviral Therapy (HAART) and to compare the same between patients on Tenofovir and non-Tenofovir based regimens. Methods A cross-sectional study was conducted. We followed 244 patients for a period of 2 years. The demographic, clinical, and laboratory parameters of the patients were recorded at baseline, one year of therapy, and two years of therapy. The data was analyzed by dividing patients into Tenofovir and non-Tenofovir based groups. Statistical analysis used the Chi-square test, paired and unpaired t-tests, and Fischer’s exact test. Results The mean BUN and serum creatinine in both groups were comparable at the start of the therapy. The decline in CrCl and eGFR in all patients on HAART for two years was statistically significant, irrespective of Tenofovir usage. The mean fall in eGFR in the Tenofovir group was 12.4 mL/min/1.73 m 2 and in the non-Tenofovir group, 9 mL/min/1.73 m 2 , though the differences between eGFR and CrCl were not significant between the two groups at any point. Conclusions Even though HAART usage has been said to slow the decline in kidney function in PLHIV, patients who receive HAART still show a statistically significant decline in renal function parameters, akin to the observations of other such studies in low-resource settings.