scholarly journals Recovery of Tenofovir-induced Nephrotoxicity following Switch from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in Human Immunodeficiency Virus-Positive Patients

2020 ◽  
Vol 52 (3) ◽  
pp. 381
Author(s):  
Jun-Won Seo ◽  
Kichun Kim ◽  
Kang Il Jun ◽  
Chang Kyung Kang ◽  
Song Mi Moon ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Tenofovir Disoproxil Fumarate ◽  
Immunodeficiency Virus ◽  
Tenofovir Alafenamide

scholarly journals Monitoring the Effects of Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide Switch for Tubulotoxicity in Highly Treatment-Experienced or in Very Sick Individuals Infected with HIV

2018 ◽  
Vol 2 (2) ◽  
pp. 1-5
Author(s):  
Nicole Lioufas ◽  
Alan Street ◽  
Paul Champion De Crespigny ◽  
Stephen G. Holt
Keyword(s):  
Chronic Kidney Disease ◽  
Human Immunodeficiency Virus ◽  
Kidney Disease ◽  
Tenofovir Disoproxil Fumarate ◽  
Serum Biochemistry ◽  
Lower Serum ◽  
Frequent Monitoring ◽  
Immunodeficiency Virus ◽  
Tubular Toxicity ◽  
Tenofovir Alafenamide

Tenofovir disoproxil fumarate (TDF) is a common antiretroviral utilised in the treatment of human immunodeficiency virus (HIV) and hepatitis B infections. It is associated with the development of tubulotoxicity and tubulopathies, and is not recommended in the treatment of patients with baseline chronic kidney disease. Until now, guidelines have suggested frequent monitoring of serum biochemistry to detect the development of such complications. In recent trials, a new prodrug formulation of tenofovir alafenamide (TAF) has been shown to exhibit less tubular toxicity than its counterpart due to a lower serum concentration of its metabolites. In this article, we share our experience with two patients who developed tubulotoxicity following the commencement of TDF-based regimens in HIV, and its improvement following its change to TAF, and review the available literature regarding tenofovir-based nephrotoxicity.

scholarly journals Switching From Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide for Human Immunodeficiency Virus Preexposure Prophylaxis at a Boston Community Health Center

2021 ◽  
Vol 8 (8) ◽  
Author(s):  
Julia L Marcus ◽  
Kenneth Levine ◽  
Whitney C Sewell ◽  
Patricia Solleveld ◽  
Kenneth H Mayer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Cardiovascular Risk ◽  
Creatinine Clearance ◽  
Cardiovascular Risk Factors ◽  
Tenofovir Disoproxil Fumarate ◽  
Community Health Center ◽  
Preexposure Prophylaxis ◽  
Immunodeficiency Virus ◽  
Tenofovir Alafenamide

Abstract Background Efforts to end the human immunodeficiency virus (HIV) epidemic may be threatened if limited preexposure prophylaxis (PrEP) resources are funneled from tenofovir disoproxil fumarate with emtricitabine (TDF/FTC) to tenofovir alafenamide with emtricitabine (TAF/FTC) without proportional clinical benefits. Methods The study population was patients at a Boston community health center who were assigned male sex at birth, aged ≥18 years, and prescribed TDF/FTC for PrEP in the 12 months before TAF/FTC approval (October 2019). We determined the frequency of switching to TAF/FTC in the 12 months after approval, including clinically indicated switching (ie, creatinine clearance <60 mL/minute or reduced bone density), potentially unnecessary switching (ie, no indications for switching and no cardiovascular risk factors), and potentially harmful switching (ie, no indications for switching and either obesity or dyslipidemia). Results Of 2892 TDF/FTC users, mean age was 38 years, 96.0% were cisgender men, and 78.9% were white. A total of 343 (11.9%) switched to TAF/FTC. Based on documented renal, bone, and cardiovascular risk factors, we identified 24 (7.0%) with clinically indicated switching, 271 (79.0%) with potentially unnecessary switching, and 48 (14.0%) with potentially harmful switching. When indications for switching additionally included hypertension, diabetes, and creatinine clearance 60–70 mL/minute, 27.1% of switching was clinically indicated. Conclusions Few who switched to TAF/FTC had documented indications for switching, although some appear to have been switched in anticipation of indications developing. As generic TDF/FTC is further discounted, provider education and patient decision aids are needed to facilitate selection of PrEP medications that is both clinically sound and cost-effective.

scholarly journals A Randomized Switch From Nevirapine-Based Antiretroviral Therapy to Single Tablet Rilpivirine/Emtricitabine/Tenofovir Disoproxil Fumarate in Virologically Suppressed Human Immunodeficiency Virus-1-Infected Rwandans

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Sean E. Collins ◽  
Philip M. Grant ◽  
Francois Uwinkindi ◽  
Annie Talbot ◽  
Eric Seruyange ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Tenofovir Disoproxil Fumarate ◽  
Sub Saharan Africa ◽  
Current Therapy ◽  
Virologic Suppression ◽  
Open Label ◽  
Immunodeficiency Virus ◽  
Sub Saharan ◽  
Hiv 1

Abstract Background.  Many human immunodeficiency virus (HIV)-infected patients remain on nevirapine-based antiretroviral therapy (ART) despite safety and efficacy concerns. Switching to a rilpivirine-based regimen is an alternative, but there is little experience with rilpivirine in sub-Saharan Africa where induction of rilpivirine metabolism by nevirapine, HIV subtype, and dietary differences could potentially impact efficacy. Methods.  We conducted an open-label noninferiority study of virologically suppressed (HIV-1 ribonucleic acid [RNA] < 50 copies/mL) HIV-1-infected Rwandan adults taking nevirapine plus 2 nucleos(t)ide reverse-transcriptase inhibitors. One hundred fifty participants were randomized 2:1 to switch to coformulated rilpivirine-emtricitabine-tenofovir disoproxil fumarate (referenced as the Switch Arm) or continue current therapy. The primary efficacy endpoint was HIV-1 RNA < 200 copies/mL at week 24 assessed by the US Food and Drug Administration Snapshot algorithm with a noninferiority margin of 12%. Results.  Between April and September 2014, 184 patients were screened, and 150 patients were enrolled; 99 patients switched to rilpivirine-emtricitabine-tenofovir, and 51 patients continued their nevirapine-based ART. The mean age was 42 years and 43% of participants were women. At week 24, virologic suppression (HIV-1 RNA level <200 copies/mL) was maintained in 93% and 92% in the Switch Arm versus the continuation arm, respectively. The Switch Arm was noninferior to continued nevirapine-based ART (efficacy difference 0.8%; 95% confidence interval, −7.5% to +12.0%). Both regimens were generally safe and well tolerated, although 2 deaths, neither attributed to study medications, occurred in participants in the Switch Arm. Conclusions.  A switch from nevirapine-based ART to rilpivirine-emtricitabine-tenofovir disoproxil fumarate had similar virologic efficacy to continued nevirapine-based ART after 24 weeks with few adverse events.

scholarly journals Acute Weight Gain After Switch to Emtricitabine/Tenofovir Alafenamide for Human Immunodeficiency Virus Pre-Exposure Prophylaxis

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Shailendra V Selvaraj ◽  
Sara H Bares ◽  
Joshua P Havens
Keyword(s):  
Human Immunodeficiency Virus ◽  
Weight Gain ◽  
Immunodeficiency Virus ◽  
Tenofovir Alafenamide ◽  
Exposure Prophylaxis

Abstract We report a case of acute weight gain after switching from emtricitabine/tenofovir disoproxil to emtricitabine/tenofovir alafenamide for human immunodeficiency virus pre-exposure prophylaxis.

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