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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
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Renal effects of novel antiretroviral drugs

James Milburn1, Rachael Jones2, Jeremy B Levy1

  • 1Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Du Cane Road, London, UK.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|May 19, 2016
PubMed

Insights

Chronic kidney disease (CKD) is common in HIV patients. Newer antiretroviral (ARV) drugs require careful monitoring for potential kidney effects and interactions.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Chronic kidney disease (CKD) is a significant comorbidity in people with HIV, affecting 2.4-17%.
  • HIV-positive individuals face increased risks of age-related diseases, cardiovascular issues, and CKD, with higher rates of smoking and dyslipidemia.
  • Proteinuria is a frequent observation in the HIV-infected population.

Purpose of the Study:

  • To review novel antiretroviral (ARV) agents and their implications for renal function in HIV patients.
  • To highlight potential nephrotoxicity and creatinine handling issues associated with new ARV drugs.
  • To inform nephrologists about newer ARV agents and their renal effects.

Main Methods:

  • Review of recently licensed ARV agents: dolutegravir, raltegravir, elvitegravir, cobicistat, tenofovir alafenamide fumarate, and atazanavir.
  • Analysis of literature concerning renal function, creatinine handling, and nephrotoxicity of these agents.
  • Discussion of interactions between HIV, ARV therapy, and CKD.

Main Results:

  • While combination ARV therapy generally reduces CKD in HIV, specific ARV drugs can be nephrotoxic, potentially worsening renal function.
  • Novel ARV agents, though highly efficacious, present unique considerations for kidney health.
  • Understanding drug interactions is crucial for managing HIV and CKD concurrently.

Conclusions:

  • Nephrologists must be aware of the renal profiles of new ARV agents.
  • Careful monitoring of renal function is essential for HIV patients on newer ARV therapies.
  • Managing CKD in the context of HIV and ARV treatment requires a comprehensive understanding of potential drug-related kidney issues.

Keywords:
HIVacute kidney injurycreatinineproteinuria

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