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Agbaji OO, Abah IO, Ebonyi AO, Gimba ZM, Abene EE, Gomerep SS, Falang KD, Anejo-Okopi J, Agaba PA, Ugoagwu PO, Agaba EI, Imade GE, Sagay AS, Okonkwo P, Idoko JA, Kanki PJ. Long Term Exposure to Tenofovir Disoproxil Fumarate-Containing Antiretroviral Therapy Is Associated with Renal Impairment in an African Cohort of HIV-Infected Adults. J Int Assoc Provid AIDS Care 2020; 18:2325958218821963. [PMID: 30672363 PMCID: PMC6546287 DOI: 10.1177/2325958218821963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES AND METHOD There are growing concerns of tenofovir disoproxil fumarate (TDF)-associated renal toxicity. We evaluated the effect of long-term TDF exposure on renal function in a cohort of HIV-1-infected Nigerians between 2006 and 2015. Multivariate logistic regression was used to identify predictors of renal impairment at different time over 144 weeks of antiretroviral therapy (ART). RESULTS Data of 4897 patients, median age 42 years (interquartile range: 36-49), and 61% females were analyzed. The prevalence of renal impairment increased from 10% at week 24 to 45% at 144 weeks in TDF-exposed participants compared to an increase from 8% at 24 weeks to 14% at 144 weeks in TDF-unexposed participants. Tenofovir disoproxil fumarate exposure predicted the risk of renal impairment at 144 weeks of ART (odds ratio: 2.36; 95% confidence interval: 1.28-4.34). CONCLUSION Long-term exposure to TDF-based ART significantly increases the likelihood of renal impairment. The continued use of TDF-based regimen in our setting should be reviewed. We recommend the urgent introduction of tenofovir alafenamide-based regimen in the HIV treatment guidelines of Nigeria and other resource-limited countries.
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Affiliation(s)
- Oche O Agbaji
- 1 Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.,2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria
| | - Isaac O Abah
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria.,3 Pharmacy Department, Jos University Teaching Hospital, Jos, Nigeria
| | - Augustine O Ebonyi
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria.,4 Department of Paediatrics, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | - Zumnan M Gimba
- 1 Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | - Esla E Abene
- 1 Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | - Simji S Gomerep
- 1 Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.,2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria
| | - Kakjing D Falang
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria.,5 Department of Pharmacology, University of Jos, Jos, Nigeria
| | - Joseph Anejo-Okopi
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria.,6 Department of Microbiology, University of Jos, Jos, Nigeria
| | - Patricia A Agaba
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria.,7 Department of Family Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | - Placid O Ugoagwu
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria
| | - Emmanuel I Agaba
- 1 Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | - Godwin E Imade
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria.,8 Department of Obstetrics and Gynaecology, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | - Atiene S Sagay
- 2 APIN-supported HIV Treatment Centre, Jos University Teaching Hospital, Jos, Nigeria.,8 Department of Obstetrics and Gynaecology, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | | | - John A Idoko
- 1 Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
| | - Phyllis J Kanki
- 10 Department of Immunology & Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Delicio AM, Abati PAM, Vigani AG. Hepatitis B virus surface antigen seroconversion in HIV-infected individual after pegylated interferon-alpha treatment: a case report. J Venom Anim Toxins Incl Trop Dis 2013; 19:31. [PMID: 24325818 PMCID: PMC4029789 DOI: 10.1186/1678-9199-19-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 11/14/2013] [Indexed: 11/10/2022] Open
Abstract
Hepatitis B virus (HBV) infects from 6 to 14% of HIV-infected individuals. Concurrent HIV/HBV infection occurs due to the overlapping routes of transmission, particularly sexual and parenteral. HIV-infected patients that have acute hepatitis B have six times greater risk of developing chronic hepatitis B, with higher viral replication, rapid progression to end-stage liver disease and shorter survival. The coinfection is also associated with poor response to hepatitis B treatment with interferon-alpha and increased liver toxicity to the antiretroviral therapy. Herein, we describe the case of a 35-year-old man who engages in sex with men and presented with newly diagnosed HIV-1, serological markers for acute hepatitis B and progression to chronic hepatitis B infection (HBsAg+ > 6 months, high alanine aminotransferase levels and moderate hepatitis as indicated by liver biopsy). Lacking indication of antiretroviral treatment (CD4 768 cells/mm3), he was treated with pegylated-interferon alpha2b (1.5 mg/kg/week) by subcutaneous injection for 48 weeks. Twelve weeks after treatment, the patient presented HBeAg seroconversion to anti-HBe. At the end of 48 weeks, he presented HBsAg seroconversion to anti-HBs. One year after treatment, the patient maintained sustained virological response (undetectable HBV-DNA). The initiation of antiretroviral therapy with nucleosides and nucleotides is recommended earlier for coinfected individuals. However, this report emphasizes that pegylated interferon remains an important therapeutic strategy to be considered for selected patients, in whom the initiation of HAART may be delayed.
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Affiliation(s)
- Adriane Maira Delicio
- Campinas Reference Center for Sexually Transmitted Diseases/AIDS, Campinas, São Paulo State, Brazil.
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Romero M, Madejón A, Fernández-Rodríguez C, García-Samaniego J. Clinical significance of occult hepatitis B virus infection. World J Gastroenterol 2011; 17:1549-52. [PMID: 21472119 PMCID: PMC3070124 DOI: 10.3748/wjg.v17.i12.1549] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 12/01/2010] [Accepted: 12/08/2010] [Indexed: 02/06/2023] Open
Abstract
Occult hepatitis B virus (HBV) infection (OBI) is defined as the presence of HBV DNA in the liver (with or without detectable HBV DNA in serum) for individuals testing HBV surface antigen negative. Until recently, the clinical effect of OBI was unclear on the progression of liver disease; on the development of hepatocellular carcinoma; and on the risk for reactivation or transmission of HBV infection. Several studies suggest a high prevalence of OBI among patients with cryptogenic chronic liver disease, but its role in the progression to cirrhosis remains unclear. Although OBI has been well documented in human immunodeficiency virus (HIV)-positive patients, especially among those coinfected with hepatitis C virus, further studies are needed to determine its current clinical impact in HIV setting.
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