Background: Tenofovir disoproxil fumarate (TDF) has been associated with kidney tubular
dysfunction and reduced renal function. Limited studies were performed in Europe and Asia
that related plasma tenofovir (TFV) concentration with renal function; no such studies to date
have been performed on Africans.
Objective: To investigate the correlation between plasma tenofovir (TFV) concentration and
certain renal function markers in HIV-infected women on TDF antiretroviral therapy (ART).
These markers were also compared to a HIV-uninfected control group.
Methods: HIV-infected women (n = 30) on TDF-based ART were matched with 30 controls for
age and body mass index. Renal markers analysed were estimated glomerular filtration rate
(eGFR), creatinine clearance (CrCl), serum creatinine, albuminuria, glucosuria, serum urea,
serum uric acid, urine sodium and maximum tubular reabsorption of phosphate. Baseline
eGFR and CrCl data were obtained retrospectively for the HIV-infected women. Plasma TFV
was assayed using a validated HPLC-MS/MS method. Stepwise regression, Mann–Whitney
test, unpaired and paired t-tests were applied in the statistical analyses.
Results: TFV concentration was independently associated with albuminuria (adjusted
r2 = 0.339; p = 0.001) in HIV-infected women. In the adjusted (weight) analysis, eGFR (p = 0.038),
CrCl (p = 0.032) and albuminuria (p = 0.048) were significantly higher in HIV-infected compared
to the uninfected women, but eGFR was abnormally high in HIV-infected women. Both eGFR
(p < 0.001) and CrCl (p = 0.008) increased from baseline to follow-up in HIV-infected women.
Conclusion: Plasma TFV concentration was associated with increased albuminuria in HIVinfected
women in this sub-study. Both eGFR and CrCl were increased in HIV-infected women
from baseline. These findings should be confirmed in larger studies, and hyperfiltration in
HIV-infected women warrants further investigation