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2017 ; 32
(3
): 434-439
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Renal effects of novel antiretroviral drugs
#MMPMID27190354
Milburn J
; Jones R
; Levy JB
Nephrol Dial Transplant
2017[Mar]; 32
(3
): 434-439
PMID27190354
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Chronic kidney disease (CKD) is a critical comorbidity for patients living with
HIV, with an estimated prevalence between 2.4 and 17%. Such patients are
increasingly affected by diseases associated with ageing, including
cardiovascular disease and CKD, and the prevalence of risk factors such as
smoking and dyslipidaemia is increased in this population. Proteinuria is also
now recognized as a common finding in individuals living with HIV. While
combination antiretroviral (ARV) treatments reduce CKD in the HIV-infected
population overall, some ARV drugs have been shown to be nephrotoxic and
associated with worsening renal function. Over the last few years, several highly
efficacious new ARV agents have been introduced. This brief review will look at
the novel agents dolutegravir, raltegravir, elvitegravir, cobicistat, tenofovir
alafenamide fumarate and atazanavir, all of which have been licensed relatively
recently, and describe issues relevant to renal function, creatinine handling and
potential nephrotoxicity. Given the prevalence of CKD, the wide range of possible
interactions between HIV, ARV therapy, CKD and its treatments, nephrologists need
to be aware of these newer agents and their possible effect on kidneys.
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