{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:24:20Z","timestamp":1740126260007,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T00:00:00Z","timestamp":1529625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Instituto Ram\u00f3n y Cajal para la Investigaci\u00f3n Sanitaria (IRYCIS)"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We investigated the reversibility of tenofovir disoproxil fumarate (<jats:styled-content style=\"fixed-case\">TDF<\/jats:styled-content>)\u2010associated renal decline and tubular dysfunction using different antiretroviral strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A successive evaluation of renal [estimated glomerular filtration rate (<jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content>)] and tubular (phosphataemia, proteinuria, albuminuria, phosphaturia, uricosuria, glycosuria and tubular proteinuria) parameters was performed in 231 patients, before and after switching from <jats:styled-content style=\"fixed-case\">TDF<\/jats:styled-content> to abacavir (<jats:italic>n<\/jats:italic> = 60), using dual therapy (<jats:italic>n<\/jats:italic> = 49), or continuing the same regimen including <jats:styled-content style=\"fixed-case\">TDF<\/jats:styled-content> (<jats:italic>n<\/jats:italic> = 122).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a successive evaluation after a median of 8.86 months, or less time if treatment was switched (4.8 months <jats:italic>vs<\/jats:italic>. 13.3 months to second evaluation; <jats:italic>P<\/jats:italic> &lt; 0.01), a significant improvement in <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> (median change +0.3 <jats:italic>vs<\/jats:italic>. \u22122.91 mL\/min\/1.73 m<jats:sup>2<\/jats:sup> in patients who did not discontinue <jats:styled-content style=\"fixed-case\">TDF<\/jats:styled-content>;<jats:italic> P<\/jats:italic> = 0.04) and tubular dysfunction (median change \u221240% <jats:italic>vs<\/jats:italic>. +30%, respectively; <jats:italic>P<\/jats:italic> &lt; 0.01) was observed. Lineal regression showed that age (<jats:italic>\u03b2<\/jats:italic> = \u22120.14; <jats:italic>P<\/jats:italic> = 0.04), previous <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> decline (<jats:italic>\u03b2<\/jats:italic> = \u20130.42; <jats:italic>P<\/jats:italic> &lt; 0.01), and time on <jats:styled-content style=\"fixed-case\">TDF<\/jats:styled-content> (<jats:italic>\u03b2<\/jats:italic> = \u22120.19; <jats:italic>P<\/jats:italic> = 0.04) were associated with impaired <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> recovery. There were no differences in <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> slopes between patients using abacavir instead of <jats:styled-content style=\"fixed-case\">TDF<\/jats:styled-content> and those using a dual therapy, who showed similar improvement in proteinuria (\u221222% <jats:italic>vs<\/jats:italic>. \u221219%, respectively), phosphaturia (+10.1% <jats:italic>vs<\/jats:italic>. +9.4%, respectively), and urinary beta\u20102\u2010microglobulin (\u22129% <jats:italic>vs<\/jats:italic>. \u221215%, respectively; <jats:italic>P<\/jats:italic> &gt; 0.1 for all), although patients receiving the dual regimen were more heavily pretreated. A <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> decrease (\u22126.17 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>) was observed in patients taking dolutegravir or rilpivirine, but with similar improvement to that observed in the rest of switching patients in tubular abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tenofovir disoproxil fumarate discontinuation was associated with a rapid and significant improvement in <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> and tubular abnormalities, regardless of whether abacavir or dual therapy was chosen. Switching to a regimen that included dolutegravir and\/or rilpivirine was associated with a <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> decrease without differences in the rate of tubular dysfunction improvement in comparison with the rest of patients who discontinued tenofovir.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12630","type":"journal-article","created":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T11:28:31Z","timestamp":1529666911000},"page":"541-550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Switching to abacavir versus use of a nucleoside\u2010sparing dual regimen for HIV\u2010infected patients with tenofovir\u2010associated renal toxicity"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7639-8591","authenticated-orcid":false,"given":"JL","family":"Casado","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Santiuste","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MJ","family":"Vivancos","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Monsalvo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MJ","family":"Perez\u2010El\u00edas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JM","family":"del Rey","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Biochemistry Ramon y Cajal Hospital Madrid 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