Effect of Tenofovir on Renal Function among Bangladeshi Adults on Long-term Antiretroviral Therapy: A Cross-sectional Study
Keywords:
Tenofovir, Renal function, AIDS, HIV, AntiretroviralAbstract
Background: Tenofovir disoproxil fumarate (TDF) is widely used in first-line antiretroviral therapy (ART) and is effective against HIV and hepatitis B, but its long-term impact on renal function is a concern. We aimed to compare renal function in HIV-positive Bangladeshi adults on TDF-containing versus non-TDF ART regimens.
Methods: This cross-sectional study was conducted at the ART Center of Bangladesh Medical University(BMU), Dhaka. We recruited 100 HIV-infected adults (age ≥18) on ART for ≥6 months, excluding those with diabetes, hypertension, chronic kidney disease, or Non-Steroidal Anti-Inflammatory Drug (NSAID) use. Seventy patients were on TDF-containing regimens and 30 on non-TDF regimens. Serum creatinine was measured, and estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease (MDRD) formula. Baseline creatinine/eGFR (at ART initiation) were obtained from records. Renal function between groups and changes from baseline within groups were analyzed using t-tests.
Results: The participants’ mean age was 36.7 years; 74% were male. After a mean of 23 months on ART, there was no significant difference in mean eGFR between the TDF and non-TDF groups (101.2 ± 27 vs 103.3 ± 28 mL/min/1.73m², p = 0.73). Only 2 patients (both in the TDF group) had eGFR <60. Within the TDF group, eGFR declined from a baseline mean of 107.9 to 101.2 (p = 0.036), with a corresponding rise in serum creatinine (0.83 to 0.90 mg/dL, p = 0.002). No significant change in renal function from baseline was observed in the non-TDF group.
Conclusions: Long-term TDF therapy was not associated with significantly worse renal function compared to non-TDF regimens in this cohort, although a mild decline in eGFR was noted in TDF-treated patients. Regular monitoring of renal function is advisable for patients on TDF. Larger longitudinal studies are recommended to confirm the long-term renal safety of TDF.
J MEDICINE 2026; 27(2): 94-101
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