Renal dysfunction by baseline CD4 cell count in a cohort of adults starting antiretroviral treatment regardless of CD4 count in the HIV Prevention Trials Network 071 [HPTN 071; Population Effect of Antiretroviral Therapy to Reduce HIV Transmission (PopART)] study in South Africa

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dc.contributor.authorBock, P.en_ZA
dc.contributor.authorNel, K.en_ZA
dc.contributor.authorFatti, G.en_ZA
dc.contributor.authorSloot, R.en_ZA
dc.contributor.authorFord, N.en_ZA
dc.contributor.authorVoget, J.en_ZA
dc.contributor.authorGunst, C.en_ZA
dc.contributor.authorGrobbelaar, N.en_ZA
dc.contributor.authorLouis, F.en_ZA
dc.contributor.authorFloyd, S.en_ZA
dc.contributor.authorHayes, R.en_ZA
dc.contributor.authorAyles, H.en_ZA
dc.contributor.authorBeyers, N.en_ZA
dc.contributor.authorFidler, S.en_ZA
dc.date.accessioned2021-10-28T06:46:25Z
dc.date.available2021-10-28T06:46:25Z
dc.date.issued2019
dc.descriptionCITATION: Bock, P., et al. 2019. Renal dysfunction by baseline CD4 cell count in a cohort of adults starting antiretroviral treatment regardless of CD4 count in the HIV Prevention Trials Network 071 [HPTN 071; Population Effect of Antiretroviral Therapy to Reduce HIV Transmission (PopART)] study in South Africa. HIV Medicine, 20(6): 392-403, doi:10.1111/hiv.12729.
dc.descriptionThe original publication is available at https://onlinelibrary.wiley.com
dc.description.abstractObjectives: Renal dysfunction is a significant cause of morbidity and mortality among HIV-positive individuals. This study evaluated renal dysfunction in a cohort of adults who started antiretroviral treatment (ART) regardless of CD4 count at three Department of Health (DOH) clinics included in the HIV Prevention Trials Network 071 (HPTN 071) Population Effect of Antiretroviral Therapy to Reduce HIV Transmission (PopART) trial. Methods: A retrospective cohort analysis of routine data for HIV-positive individuals starting ART between January 2014 and November 2015 was completed. Incident renal dysfunction was defined as an estimated glomerular filtration rate (eEGFR) < 60 mL/min after ART initiation among individuals with a baseline (pre-ART) eGFR ≥ 60 mL/min. Results: Overall, 2423 individuals, with a median baseline CD4 count of 328 cells/μL [interquartile range (IQR) 195–468 cells/μL], were included in the analysis. Forty-seven individuals had a baseline eGFR < 60 mL/min. Among 1634 nonpregnant individuals started on a tenofovir-containing ART regimen and with a baseline eGFR ≥ 60 mL/min, 27 developed an eGFR < 60 mL/min on ART. Regression analysis showed lower odds of baseline eGFR < 60 mL/min at baseline CD4 counts of > 500 cells/μL [adjusted odds ratio (aOR) 0.29; 95% confidence interval (CI) 0.11–0.80], 351–500 cells/μL (aOR 0.22; 95% CI 0.08–0.59) and 201–350 (aOR 0.48; 95% CI: 0.24–0.97) compared with baseline CD4 counts < 200 cells/μL. Conclusions: This study showed low rates of renal dysfunction at baseline and on ART, with lower rates of baseline renal dysfunction among individuals with baseline CD4 counts > 200 cells/μL. Strategies that use baseline characteristics, such as age, to identify individuals at high risk of renal dysfunction on ART for enhanced eGFR monitoring may be effective and should be the subject of future research.en_ZA
dc.description.urihttps://onlinelibrary.wiley.com/doi/10.1111/hiv.12729
dc.description.versionPublisher's version
dc.format.extent12 pagesen_ZA
dc.identifier.citationBock, P., et al. 2019. Renal dysfunction by baseline CD4 cell count in a cohort of adults starting antiretroviral treatment regardless of CD4 count in the HIV Prevention Trials Network 071 [HPTN 071; Population Effect of Antiretroviral Therapy to Reduce HIV Transmission (PopART)] study in South Africa. HIV Medicine, 20(6): 392-403, doi:10.1111/hiv.12729
dc.identifier.issn1468-1293 (online)
dc.identifier.issn1464-2662 (print)
dc.identifier.otherdoi:10.1111/hiv.12729
dc.identifier.urihttp://hdl.handle.net/10019.1/123323
dc.language.isoen_ZAen_ZA
dc.publisherWileyen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectRenal dysfunctionen_ZA
dc.subjectKidneys -- Diseasesen_ZA
dc.subjectCD4 antigenen_ZA
dc.subjectAntiretroviral agentsen_ZA
dc.subjectHIV infections -- Preventionen_ZA
dc.titleRenal dysfunction by baseline CD4 cell count in a cohort of adults starting antiretroviral treatment regardless of CD4 count in the HIV Prevention Trials Network 071 [HPTN 071; Population Effect of Antiretroviral Therapy to Reduce HIV Transmission (PopART)] study in South Africaen_ZA
dc.typeArticleen_ZA
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