Contemporary Protease Inhibitor for HIV Increases Risk of CKD Over the Long Term
While there is no significant association between ritonavir-boosted darunavir (DRV/r) use and chronic kidney disease (CKD) in patients with HIV, CKD incidence among individuals with HIV increases with longer use of ritonavir-boosted atazanavir (ATV/r), according to findings from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study.1
To reach this conclusion, the researchers followed participants of the D:A:D study until either:
- The earliest occurrence of CKD,
- The last visit plus 6 months, or
- February 1, 2016.
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Enrollment of patients with HIV-1 into D:A:D began in 1999, and data on the participants were collected at least every 8 months.2
By assessing for the association between CKD and contemporary protease inhibitors, the researchers determined that the incidence of CKD (10.0/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r. However, the relationship between CKD and DRV/r was less clear.
The relationship between ATV/r exposure and CKD—but not the relationship between DRV/r and CKD—remained significant after adjustment.
—Colleen Murphy
References:
- 1. Ryom L, Lundgren JD, Reiss P, et al; Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study Group. Use of contemporary protease inhibitors and risk of incident chronic kidney disease in persons with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. J Infect Dis. 2019;220(10):1629-1634. https://doi.org/10.1093/infdis/jiz369.
- 2. Worm SW. Data collection on adverse events of anti-HIV drugs: the D:A:D Study. Copenhagen HIV Programme. http://www.encepp.eu/documents/publications/6.2_DAD%20Collaboration,%20S%20Worm.pdf. Accessed November 5, 2019.