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Liver, Kidney & Bone Toxicity

Tenofovir, Protease Inhibitors Linked to Kidney Impairment

Use of tenofovir disoproxil fumarate (TDF) is associated with reduced kidney function, though for most people the change is small, does not progress with continued exposure, and improves after stopping the drug, according to several recently published studies. Some analyses found that certain HIV protease inhibitors can also cause kidney problems.

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ICAAC 2012: Atazanavir Linked to Kidney Stones in People with HIV

HIV positive people taking ritonavir-boosted atazanavir (Reyataz) are more likely to develop kidney stones than those using other antiretroviral medications, according to study data presented at the recent 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2012) in San Francisco and published in the November 1, 2012 issue of Clinical Infectious Diseases. Another study suggested that darunavir (Prezista) may also raise the risk.alt

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IDSA: Tenofovir Not Linked to Increased Kidney Risk in HIV+ Veterans Study

Use of tenofovir (Viread, also in the Truvada and Atripla coformulations) was not associated with a higher risk of kidney toxicity compared with other antiretroviral agents, according to a study presented at the 49th Annual Meeting of the Infectious Diseases Society of America (IDSA 2011) last month in Boston.alt

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NIH Offers Free Database of Drugs Associated with Liver Injury

The National Institutes of Health (NIH) last week launched the new LiverTox database of drugs known to have the potential to cause liver toxicity -- the leading cause of acute liver failure in the U.S. In addition to prescription drugs, it also includes over-the-counter medications, herbal remedies, and supplements. A number of antiretroviral drugs used to treat HIV appear on the list. alt

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ICAAC: Cobicistat Matches Ritonavir as Booster, Studies Clarify Effects on Kidney Function

The experimental pharmacoenhancing agent cobicistat continues to work as well as ritonavir for boosting other antiretroviral drugs, according to findings published in the September 24, 2011, issue of AIDS.

In addition, 2 studies presented this week at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2011) shed further light on cobicistat's impact on the kidneys, indicating that it reduces estimated but not actual glomerular filtration rate (GFR) by altering activity in the proximal renal tubules.alt

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CROI: ART Liver Toxicity is Lower with Modern Regimens, but Still a Risk for HIV/HCV Coinfected

Liver toxicity related to antiretroviral therapy (ART) has become less common in recent years thanks to development of better tolerated drugs and improved understanding of how to use them. But HIV positive people coinfected with hepatitis C remain at higher risk, researchers reported at the 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012) this month in Seattle.alt

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Meta-analysis Finds Tenofovir Linked to Modest Kidney Impairment, No Increase in Bone Fractures

Use of tenofovir (Viread, also in the Truvada and Atripla combination pills) was found to be associated with statistically significant loss of kidney function in a systematic review and meta-analysis, but this was considered to have only a modest clinical impact, researchers reported in the September 15, 2010 issue of Clinical Infectious Diseases. This review also found no link between tenofovir and bone fractures. Researchers concluded that tenofovir use does not need to be limited in areas where kidney function cannot be adequately monitored.

UCSF Answers Patient and Provider Questions about Tenofovir Kidney Study

The University of California at San Francisco (UCSF) has issued a set of frequently asked question and answers for patients and clinicians regarding a study in this week's issue of AIDS finding a link between tenofovir (Viread, also in the Truvada and Atripla combination pills) and kidney impairment.alt

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Antiretroviral Treatment Interruption Is Associated with Evidence of Kidney Dysfunction in SMART Study

Evidence continues to accumulate showing that antiretroviral treatment interruption, as evaluated in the large SMART trial, is a potentially risky strategy. A new study, published in the January 2, 2009 issue of AIDS, sheds further light on kidney dysfunction in this setting.

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Large Study Finds Tenofovir Linked to Increased Kidney Risk

HIV positive people who took tenofovir (Viread, also in the Truvada and Atripla combination pills) were more likely to show signs of impaired kidney function, according to an observational study of more than 10,000 people described in the February 4, 2012, advance online edition of AIDS. alt

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