ENOFOVIR DISOPROXIL FUMARATE ASSOCITED RENAL DYSFUNCTION AMONG ADULTS ON ANTIRETROVIRAL THERAPY AT THE UNIVERSITY OF GONDAR COMPREHENSIVE AND SPECIALIZED HOSPITAL (UOGCSH), NORTHWEST ETHIOPIA, 2019: RETROSPECTIVE COHORT STUDY.

Abstract

ABSTRACT Background: The use of tenofovir disoproxil fumarate (TDF) has been reported to be a significant contributor to renal dysfunction However, there is no adequate data on its effect on renal function in Ethiopia. Objective: tenofovir disoproxil fumarate renal dysfunction among adult HIV patients at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia. Methods: A retrospective cohort study was conducted at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Patients who started TDF and non-TDF based regimen between January 2015 and June 2019 were included in this study. The estimated glomerular filtration rate (eGFR) was estimated by Chronic Kidney Disease Epidemiology(CKD-EPI) equation. Renal dysfunction was defined as GFR <60 mL/min/1.73 m 2 decrease of baseline eGFR. Data were collected from the patient charts. It was entered into EpiInfo TM 7 software. Then it was transformed into SPSS® software version 20 and analyzed. The descriptive statistics were summarized by using mean, frequency, and proportion. Baseline characteristics of the TDF and non-TDF groups were compared by Chisquare.

The Kaplan–Meier method was used to estimate the survival curves. Cox's proportional hazards models were used to identify predictors of renal dysfunction using a 95% confidence interval and p-value ? 0.05 as a statistical significance. Result: Out of 400 participants, 200 were TDF -based ART group and 200 were non- TDF based ART groups. The incidence of renal dysfunction of TDF and non-TDF group was 28.31 per 100 person-years (PYs) and 12.53 per 100 PYs, respectively. The use of TDF based regimen associated with renal dysfunction around 2 (AHR = 1.696; 95% CI = 1.0212.817; p =0.041) times at higher risk of renal dysfunction than non-TDF based regimen. Age

?55,

diabetes mellitus, concurrent nephrotoxic drug use, and combined use of ritonavirboosted protease inhibitors were also associate significantly with renal dysfunction.

Conclusion:

The incidence rate of renal dysfunction among TDF users is higher than non- TDF users. Exposure to TDF is a significant risk of renal dysfunction in HIV-infected adult patients. All concerned bodies should regularly monitor the renal function of HIV patients who are taking TDF. Keywords: - Antiretroviral therapy, renal dysfunction, tenofovir disoproxil fumarate, Estimated Glomerular filtration rate, Gondar, Ethiopia