RESEARCH ARTICLE
Low Incidence of Renal Dysfunction among HIV-Infected Patients on a Tenofovir-Based First Line Antiretroviral Treatment Regimen in Myanmar Nang Thu Thu Kyaw1*, Anthony D. Harries2,3☯, Palanivel Chinnakali4☯, Annick Antierens5‡, Kyi Pyar Soe1‡, Mike Woodman6‡, Mrinalini Das7‡, Sharmila Shetty1☯, Moe Khine Lwin Zuu1‡, Pyae Sone Htwe1‡, Marcelo Fernandez1☯ 1 Médecins Sans Frontières- Switzerland, Yangon, Myanmar, 2 International Union against Tuberculosis and Lung Disease, Paris, France, 3 London School of Hygiene and Tropical Medicine, London, United Kingdom, 4 Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, 5 Médecins Sans Frontières, Bruxelles, Belgium, 6 Médecins Sans Frontières, Geneva, Switzerland, 7 Médecins Sans Frontières/Doctors Without Borders, New Delhi, India ☯ These authors contributed equally to this work. ‡ These authors also contributed equally to this work. * [email protected] OPEN ACCESS Citation: Kyaw NTT, Harries AD, Chinnakali P, Antierens A, Soe KP, Woodman M, et al. (2015) Low Incidence of Renal Dysfunction among HIV-Infected Patients on a Tenofovir-Based First Line Antiretroviral Treatment Regimen in Myanmar. PLoS ONE 10(8): e0135188. doi:10.1371/journal.pone.0135188 Editor: Dimitrios Paraskevis, University of Athens, Medical School, GREECE Received: March 10, 2015
Abstract Background Since 2004, Médecins Sans Frontières-Switzerland has provided treatment and care for people living with HIV in Dawei, Myanmar. Renal function is routinely monitored in patients on tenofovir (TDF)-based antiretroviral treatment (ART), and this provides an opportunity to measure incidence and risk factors for renal dysfunction.
Accepted: July 19, 2015 Published: August 24, 2015
Methods
Copyright: © 2015 Kyaw et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We used routinely collected program data on all patients aged 15 years starting first-line TDF-based ART between January 2012 and December 2013. Creatinine clearance (CrCl) was assessed at base line and six-monthly, with renal dysfunction defined as CrCl < 50ml/ min/1.73m2. We calculated incidence of renal dysfunction and used Cox regression analysis to identify associated risk factors.
Data Availability Statement: A raw data set is available as a Supporting Information file.
Results
Funding: The programme was funded by The Union, MSF, The Department for International Development (DFID), UK and the World Health Organization. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.
There were 1391 patients, of whom 1372 had normal renal function at baseline. Of these, 86 (6.3%) developed renal dysfunction during a median time of follow-up 1.14 years with an incidence rate of 5.4 per 100 person-years: 78 had CrCl between 30–50ml/min/1.73m2 and were maintained on TDF–based ART, but 5 were changed to another regimen: 4 because of CrCl
Low Incidence of Renal Dysfunction among HIV-Infected Patients on a Tenofovir-Based First Line Antiretroviral Treatment Regimen in Myanmar Nang Thu Thu Kyaw1*, Anthony D. Harries2,3☯, Palanivel Chinnakali4☯, Annick Antierens5‡, Kyi Pyar Soe1‡, Mike Woodman6‡, Mrinalini Das7‡, Sharmila Shetty1☯, Moe Khine Lwin Zuu1‡, Pyae Sone Htwe1‡, Marcelo Fernandez1☯ 1 Médecins Sans Frontières- Switzerland, Yangon, Myanmar, 2 International Union against Tuberculosis and Lung Disease, Paris, France, 3 London School of Hygiene and Tropical Medicine, London, United Kingdom, 4 Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, 5 Médecins Sans Frontières, Bruxelles, Belgium, 6 Médecins Sans Frontières, Geneva, Switzerland, 7 Médecins Sans Frontières/Doctors Without Borders, New Delhi, India ☯ These authors contributed equally to this work. ‡ These authors also contributed equally to this work. * [email protected] OPEN ACCESS Citation: Kyaw NTT, Harries AD, Chinnakali P, Antierens A, Soe KP, Woodman M, et al. (2015) Low Incidence of Renal Dysfunction among HIV-Infected Patients on a Tenofovir-Based First Line Antiretroviral Treatment Regimen in Myanmar. PLoS ONE 10(8): e0135188. doi:10.1371/journal.pone.0135188 Editor: Dimitrios Paraskevis, University of Athens, Medical School, GREECE Received: March 10, 2015
Abstract Background Since 2004, Médecins Sans Frontières-Switzerland has provided treatment and care for people living with HIV in Dawei, Myanmar. Renal function is routinely monitored in patients on tenofovir (TDF)-based antiretroviral treatment (ART), and this provides an opportunity to measure incidence and risk factors for renal dysfunction.
Accepted: July 19, 2015 Published: August 24, 2015
Methods
Copyright: © 2015 Kyaw et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We used routinely collected program data on all patients aged 15 years starting first-line TDF-based ART between January 2012 and December 2013. Creatinine clearance (CrCl) was assessed at base line and six-monthly, with renal dysfunction defined as CrCl < 50ml/ min/1.73m2. We calculated incidence of renal dysfunction and used Cox regression analysis to identify associated risk factors.
Data Availability Statement: A raw data set is available as a Supporting Information file.
Results
Funding: The programme was funded by The Union, MSF, The Department for International Development (DFID), UK and the World Health Organization. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.
There were 1391 patients, of whom 1372 had normal renal function at baseline. Of these, 86 (6.3%) developed renal dysfunction during a median time of follow-up 1.14 years with an incidence rate of 5.4 per 100 person-years: 78 had CrCl between 30–50ml/min/1.73m2 and were maintained on TDF–based ART, but 5 were changed to another regimen: 4 because of CrCl
