%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Le, M. P.
%A Landman, R.
%A Koulla-Shiro, S.
%A Charpentier, C.
%A Sow, P. S.
%A Diallo, M. B.
%A Gueye, N. F. N.
%A Ngolle, M.
%A Le Moing, V.
%A Eymard-Duvernay, Sabrina
%A Benalycherif, A.
%A Delaporte, Eric
%A Girard, P. M.
%A Peytavin, G.
%T Tenofovir plasma concentrations related to estimated glomerular filtration rate changes in first-line regimens in African HIV-infected patients : ANRS 12115 DAYANA substudy
%D 2015
%L fdi:010064704
%G ENG
%J Journal of Antimicrobial Chemotherapy
%@ 0305-7453
%K antiretroviral therapy ; ART ; drug monitoring
%K SENEGAL ; CAMEROUN ; AFRIQUE SUBSAHARIENNE
%M ISI:000355932800032
%N 5
%P 1517-1521
%R 10.1093/jac/dku532
%U https://www.documentation.ird.fr/hor/fdi:010064704
%> https://www.documentation.ird.fr/intranet/publi/2015/07/010064704.pdf
%V 70
%W Horizon (IRD)
%X Objectives: An open-label randomized trial (DAYANA) was conducted in sub-Saharan settings to evaluate four different regimens containing tenofovir disoproxil fumarate as first-line treatment for HIV infection. The objectives of the present substudy were to assess the relationship between trough concentrations of tenofovir in plasma collected after 24 h (C-24) and estimated glomerular filtration rates (eGFR) calculated by the different formulae that are available. Methods: The criteria for eligibility were those of the DAYANA trial, recruiting naive patients. The four tenofovir regimens were: Group 1, tenofovir/emtricitabine/nevirapine; Group 2, tenofovir/lopinavir/ritonavir; Group 3, tenofovir/emtricitabine/zidovudine; and Group 4, tenofovir/emtricitabine/efavirenz. The C-24 of tenofovir was determined using LC-MS/MS. The eGFR was calculated using the Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulae. Results: The median C-24 of tenofovir was 42 ng/mL. The C-24 of tenofovir was higher with lopinavir/ritonavir than with the other three regimens: at Week 4, 84 ng/mL versus 25 ng/mL; and at Week 48, 81 ng/mL versus 52 ng/mL. The baseline merged eGFR was 98.2 mL/min/1.73 m(2) with the CKD-EPI equation. Only the mean changes in eGFR in Group 2 differed from the absolute value of zero (-.2 mL/min/1.73 m(2)) with the CKD-EPI equation between baseline and Week 48. The Cockcroft-Gault formula is inappropriate for these African patients because it underestimated the baseline eGFR and overestimated the changes in eGFR between baseline and Week 48. Conclusions: In this population of mostly female HIV-1-infected African patients, tenofovir plasma overexposure was associated with PI/ritonavir and a time-dependent decrease in eGFR, probably via an inhibition of MRP2/MRP4 efflux transporters. The close monitoring over time of the eGFR using MDRD or CKD-EPI calculations and by using other biomarkers of renal disorder should be proposed as an alternative to therapeutic drug monitoring in resource-limited countries.
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