Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine
Introduction: Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is used as oral preexposure prophylaxis (PrEP) to prevent HIV. Because TDF could be nephrotoxic, we assessed the association between PrEP use and kidney function over time. Methods: We included men who have sex with men (MSM) from t...
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2025-06-01
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| author | Dita C. Bolluyt Mark A.M. van den Elshout Eline S. Wijstma Anders Boyd Elske Hoornenborg Henry J.C. De Vries Maria Prins Liffert Vogt Maarten F. Schim van der Loeff T. van Benthem D. Bons G.J. de Bree P. Brokx U. Davidovich S. Hendriks S.E. Geerlings M. Heidenrijk E. Hoornenborg J. Heijne P. Reiss A. van Sighem M. van der Valk J. de Wit P. Zantkuijl N. Schat L. Dol M. van Agtmael J. Ananworanich D. Van de Beek G.E.L. van den Berk D. Bezemer A. van Bijnen J.P. Bil W.L. Blok S. Bogers M. Bomers A. Boyd W. Brokking D. Burger K. Brinkman N. Brinkman M. de Bruin S. Bruisten L. Coyer R. van Crevel M. Dijkstra Y.T. van Duijnhoven A. van Eeden L. Elsenburg M.A.M. van den Elshout E. Ersan P.E.V. Felipa T.B.H. Geijtenbeek J. van Gool A. Goorhuis M. Groot C.A. Hankins A. Heijnen M.M.J. Hillebregt M. Hommenga J.W. Hovius Y. Janssen K. de Jong V. Jongen N.A. Kootstra R.A. Koup F.P. Kroon T.J.W. van de Laar F. Lauw M.M. van Leeuwen K. Lettinga I. Linde D.S.E. Loomans I.M. van der Lubben J.T. van der Meer T. Mouhebati B.J. Mulder J. Mulder F.J. Nellen A. Nijsters H. Nobel E.L.M. Op de Coul E. Peters I.S. Peters T. van der Poll O. Ratmann C. Rokx M.F. Schim van der Loeff W.E.M. Schoute J. Schouten J. Veenstra A. Verbon F. Verdult J. de Vocht H.J. de Vries S. Vrouenraets M. van Vugt W.J. Wiersinga F.W. Wit L.R. Woittiez S. Zaheri P. Zantkuijl Żakowicz M.C. van Zelm H.M.L. Zimmermann |
| author_facet | Dita C. Bolluyt Mark A.M. van den Elshout Eline S. Wijstma Anders Boyd Elske Hoornenborg Henry J.C. De Vries Maria Prins Liffert Vogt Maarten F. Schim van der Loeff T. van Benthem D. Bons G.J. de Bree P. Brokx U. Davidovich S. Hendriks S.E. Geerlings M. Heidenrijk E. Hoornenborg J. Heijne P. Reiss A. van Sighem M. van der Valk J. de Wit P. Zantkuijl N. Schat L. Dol M. van Agtmael J. Ananworanich D. Van de Beek G.E.L. van den Berk D. Bezemer A. van Bijnen J.P. Bil W.L. Blok S. Bogers M. Bomers A. Boyd W. Brokking D. Burger K. Brinkman N. Brinkman M. de Bruin S. Bruisten L. Coyer R. van Crevel M. Dijkstra Y.T. van Duijnhoven A. van Eeden L. Elsenburg M.A.M. van den Elshout E. Ersan P.E.V. Felipa T.B.H. Geijtenbeek J. van Gool A. Goorhuis M. Groot C.A. Hankins A. Heijnen M.M.J. Hillebregt M. Hommenga J.W. Hovius Y. Janssen K. de Jong V. Jongen N.A. Kootstra R.A. Koup F.P. Kroon T.J.W. van de Laar F. Lauw M.M. van Leeuwen K. Lettinga I. Linde D.S.E. Loomans I.M. van der Lubben J.T. van der Meer T. Mouhebati B.J. Mulder J. Mulder F.J. Nellen A. Nijsters H. Nobel E.L.M. Op de Coul E. Peters I.S. Peters T. van der Poll O. Ratmann C. Rokx M.F. Schim van der Loeff W.E.M. Schoute J. Schouten J. Veenstra A. Verbon F. Verdult J. de Vocht H.J. de Vries S. Vrouenraets M. van Vugt W.J. Wiersinga F.W. Wit L.R. Woittiez S. Zaheri P. Zantkuijl Żakowicz M.C. van Zelm H.M.L. Zimmermann |
| author_sort | Dita C. Bolluyt |
| collection | DOAJ |
| description | Introduction: Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is used as oral preexposure prophylaxis (PrEP) to prevent HIV. Because TDF could be nephrotoxic, we assessed the association between PrEP use and kidney function over time. Methods: We included men who have sex with men (MSM) from the Amsterdam PrEP demonstration Project (AMPrEP; 2015–2020) at the Public Health Service of Amsterdam, who had an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min per 1.73 m2 and ≥ 1 creatinine measurement after baseline. Participants could choose between daily or event-driven PrEP use. Plasma creatinine was measured at PrEP commencement and annually thereafter. Kidney function was calculated as the eGFR using the 2021 Chronic Kidney Disease-Epidemiology Collaboration formula. Results: Among the 351 participants analyzed (median age: 41 years, interquartile range [IQR] = 33–49), mean eGFR at PrEP commencement was 100 ml/min per 1.73 m2 (SD = 14). During a median follow-up of 54.2 months (IQR = 47.0–57.6), eGFR decreased by 0.30/yr (95% confidence interval [CI] = − 0.59 to − 0.01). We observed lower mean eGFR decline in those using daily PrEP than in those using event-driven PrEP (− 3.05, 95% CI = − 3.95 to − 2.15), and in older participants (− 5.75/10 yrs, 95% CI = − 6.70 to − 4.80). Daily PrEP users had an average decline in eGFR of 0.57 ml/min per 1.73 m2/yr (95% CI = − 1.06 to − 0.08), and there was no statistically significant decline in event-driven PrEP users (P for interaction = 0.30). Twelve participants (3.4%) had an incident eGFR < 60 during follow-up, none of which persisted. Conclusion: Daily PrEP users had a faster decline over time than event-driven PrEP users, yet eGFR declines were low and within the range of those expected in the general population. Our data support reduced kidney function monitoring in PrEP users at low risk for kidney dysfunction. |
| format | Article |
| id | doaj-art-704988faf7cd47c0bfcc725e96b9eb6b |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-704988faf7cd47c0bfcc725e96b9eb6b2025-08-20T03:46:58ZengElsevierKidney International Reports2468-02492025-06-011062003201410.1016/j.ekir.2025.03.033Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/EmtricitabineDita C. Bolluyt0Mark A.M. van den Elshout1Eline S. Wijstma2Anders Boyd3Elske Hoornenborg4Henry J.C. De Vries5Maria Prins6Liffert Vogt7Maarten F. Schim van der Loeff8T. van BenthemD. BonsG.J. de BreeP. BrokxU. DavidovichS. HendriksS.E. GeerlingsM. HeidenrijkE. HoornenborgJ. HeijneP. ReissA. van SighemM. van der ValkJ. de WitP. ZantkuijlN. SchatL. DolM. van AgtmaelJ. AnanworanichD. Van de BeekG.E.L. van den BerkD. BezemerA. van BijnenJ.P. BilW.L. BlokS. BogersM. BomersA. BoydW. BrokkingD. BurgerK. BrinkmanN. BrinkmanM. de BruinS. BruistenL. CoyerR. van CrevelM. DijkstraY.T. van DuijnhovenA. van EedenL. ElsenburgM.A.M. van den ElshoutE. ErsanP.E.V. FelipaT.B.H. GeijtenbeekJ. van GoolA. GoorhuisM. GrootC.A. HankinsA. HeijnenM.M.J. HillebregtM. HommengaJ.W. HoviusY. JanssenK. de JongV. JongenN.A. KootstraR.A. KoupF.P. KroonT.J.W. van de LaarF. LauwM.M. van LeeuwenK. LettingaI. LindeD.S.E. LoomansI.M. van der LubbenJ.T. van der MeerT. MouhebatiB.J. MulderJ. MulderF.J. NellenA. NijstersH. NobelE.L.M. Op de CoulE. PetersI.S. PetersT. van der PollO. RatmannC. RokxM.F. Schim van der LoeffW.E.M. SchouteJ. SchoutenJ. VeenstraA. VerbonF. VerdultJ. de VochtH.J. de VriesS. VrouenraetsM. van VugtW.J. WiersingaF.W. WitL.R. WoittiezS. ZaheriP. Zantkuijl ŻakowiczM.C. van ZelmH.M.L. ZimmermannDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Correspondence: Dita C. Bolluyt, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The NetherlandsDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The NetherlandsDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Stichting HIV Monitoring, Amsterdam, The Netherlands; Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The NetherlandsDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, The NetherlandsDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsIntroduction: Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is used as oral preexposure prophylaxis (PrEP) to prevent HIV. Because TDF could be nephrotoxic, we assessed the association between PrEP use and kidney function over time. Methods: We included men who have sex with men (MSM) from the Amsterdam PrEP demonstration Project (AMPrEP; 2015–2020) at the Public Health Service of Amsterdam, who had an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min per 1.73 m2 and ≥ 1 creatinine measurement after baseline. Participants could choose between daily or event-driven PrEP use. Plasma creatinine was measured at PrEP commencement and annually thereafter. Kidney function was calculated as the eGFR using the 2021 Chronic Kidney Disease-Epidemiology Collaboration formula. Results: Among the 351 participants analyzed (median age: 41 years, interquartile range [IQR] = 33–49), mean eGFR at PrEP commencement was 100 ml/min per 1.73 m2 (SD = 14). During a median follow-up of 54.2 months (IQR = 47.0–57.6), eGFR decreased by 0.30/yr (95% confidence interval [CI] = − 0.59 to − 0.01). We observed lower mean eGFR decline in those using daily PrEP than in those using event-driven PrEP (− 3.05, 95% CI = − 3.95 to − 2.15), and in older participants (− 5.75/10 yrs, 95% CI = − 6.70 to − 4.80). Daily PrEP users had an average decline in eGFR of 0.57 ml/min per 1.73 m2/yr (95% CI = − 1.06 to − 0.08), and there was no statistically significant decline in event-driven PrEP users (P for interaction = 0.30). Twelve participants (3.4%) had an incident eGFR < 60 during follow-up, none of which persisted. Conclusion: Daily PrEP users had a faster decline over time than event-driven PrEP users, yet eGFR declines were low and within the range of those expected in the general population. Our data support reduced kidney function monitoring in PrEP users at low risk for kidney dysfunction.http://www.sciencedirect.com/science/article/pii/S2468024925001767eGFRHIVkidney functionmen who have sex with menpreexposure prophylaxis |
| spellingShingle | Dita C. Bolluyt Mark A.M. van den Elshout Eline S. Wijstma Anders Boyd Elske Hoornenborg Henry J.C. De Vries Maria Prins Liffert Vogt Maarten F. Schim van der Loeff T. van Benthem D. Bons G.J. de Bree P. Brokx U. Davidovich S. Hendriks S.E. Geerlings M. Heidenrijk E. Hoornenborg J. Heijne P. Reiss A. van Sighem M. van der Valk J. de Wit P. Zantkuijl N. Schat L. Dol M. van Agtmael J. Ananworanich D. Van de Beek G.E.L. van den Berk D. Bezemer A. van Bijnen J.P. Bil W.L. Blok S. Bogers M. Bomers A. Boyd W. Brokking D. Burger K. Brinkman N. Brinkman M. de Bruin S. Bruisten L. Coyer R. van Crevel M. Dijkstra Y.T. van Duijnhoven A. van Eeden L. Elsenburg M.A.M. van den Elshout E. Ersan P.E.V. Felipa T.B.H. Geijtenbeek J. van Gool A. Goorhuis M. Groot C.A. Hankins A. Heijnen M.M.J. Hillebregt M. Hommenga J.W. Hovius Y. Janssen K. de Jong V. Jongen N.A. Kootstra R.A. Koup F.P. Kroon T.J.W. van de Laar F. Lauw M.M. van Leeuwen K. Lettinga I. Linde D.S.E. Loomans I.M. van der Lubben J.T. van der Meer T. Mouhebati B.J. Mulder J. Mulder F.J. Nellen A. Nijsters H. Nobel E.L.M. Op de Coul E. Peters I.S. Peters T. van der Poll O. Ratmann C. Rokx M.F. Schim van der Loeff W.E.M. Schoute J. Schouten J. Veenstra A. Verbon F. Verdult J. de Vocht H.J. de Vries S. Vrouenraets M. van Vugt W.J. Wiersinga F.W. Wit L.R. Woittiez S. Zaheri P. Zantkuijl Żakowicz M.C. van Zelm H.M.L. Zimmermann Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine Kidney International Reports eGFR HIV kidney function men who have sex with men preexposure prophylaxis |
| title | Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine |
| title_full | Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine |
| title_fullStr | Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine |
| title_full_unstemmed | Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine |
| title_short | Renal Outcomes Over the Course of 5 Years of Oral HIV Preexposure Prophylaxis Using Tenofovir Disoproxil/Emtricitabine |
| title_sort | renal outcomes over the course of 5 years of oral hiv preexposure prophylaxis using tenofovir disoproxil emtricitabine |
| topic | eGFR HIV kidney function men who have sex with men preexposure prophylaxis |
| url | http://www.sciencedirect.com/science/article/pii/S2468024925001767 |
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renaloutcomesoverthecourseof5yearsoforalhivpreexposureprophylaxisusingtenofovirdisoproxilemtricitabine |