@article{fdi:010072038,
  title = {{E}volution of renal function in {A}frican patients initiating second-line antiretroviral treatment : findings from the {ANRS} 12169 2{LADY} trial},
  author = {{C}ournil, {A}mandine and {H}ema, {A}. and {E}ymard-{D}uvernay, {S}abrina and {C}iaffi, {L}. and {B}adiou, {S}. and {K}abore, {F}. {N}. and {D}iouf, {A}. and {A}yangma, {L}. and {L}e {M}oing, {V}. and {R}eynes, {J}. and {K}oulla-{S}hiro, {S}. and {D}elaporte, {E}ric and {L}ady {S}tudy {G}rp},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}o investigate change in renal function in {A}frican patients initiating second-line antiretroviral therapy ({ART}) including ritonavir-boosted protease inhibitor ({PI}/r) with or without tenofovir disoproxil fumarate ({TDF}). {M}ethods: {HIV}-1-positive adults, failing standard first-line {ART} were randomized to either {TDF}/emtricitabine ({FTC})+{LPV}/r, abacavir + didanosine +{LPV}/r or {TDF}/{FTC}+darunavir ({DRV})/r and followed for 18 months. {P}atients with an estimated glomerular filtration rate (e{GFR}) >= 60 ml/min/1.73 m(2) at baseline were included in this analysis. {R}esults: {D}ata from 438 out of 454 randomized patients were analysed. {M}edian age was 38 years and 72% were women. {I}nitiation of {PI}/r-based second-line regimen induced a marked e{GFR} decline of -10.5 ml/min/1.73 m2 at week 4 in all treatment groups with a greater decrease in {TDF}/{FTC}+{LPV}/r arm (-15.1 ml/min/1.73 m(2)). {A}t month 18, mean e{GFR} in the non-{TDF} containing regimen recovered its baseline level and was significantly greater than e{GFR} 18-month levels in the {TDF}-containing regimens that experienced only partial recovery (difference: -10.7; {CI} -16.8, -4.6; {P}=0.001 in {TDF}/{FTC}+{LPV}/r and -6.4; {CI} -12.5, -0.3; {P}=0.04 in {TDF}/{FTC}+{DRV}/r). {A}t 18 months, prevalence of stage 3 chronic kidney disease was low (<3%) and not associated with treatment. {O}ne treatment discontinuation and five {TDF} dosage reductions for renal toxicities were reported in {TDF}-containing arms. {C}onclusions: {O}verall, these results suggest a reasonable renal tolerance of a regimen associating {TDF}/{FTC}+ {PI}/r in {A}frican patients with e{GFR}>60 ml/ml/1.73 m(2) at baseline. {T}hey also support the recommendation of reassessing renal function 1 month after initiation of treatment including ritonavir to account for the ritonavir-related artefactual decrease of e{GFR} and determine the new reference baseline value.},
  keywords = {{CAMEROUN} ; {BURKINA} {FASO} ; {SENEGAL} ; {YAOUNDE} ; {BOBO} {DIOULASSO} ; {DAKAR}},
  booktitle = {},
  journal = {{A}ntiviral {T}herapy},
  volume = {22},
  numero = {3},
  pages = {195--203},
  ISSN = {1359-6535},
  year = {2017},
  DOI = {10.3851/imp3097},
  URL = {https://www.documentation.ird.fr/hor/fdi:010072038},
}