التفاصيل البيبلوغرافية
| العنوان: |
Impact of early versus deferred antiretroviral therapy on estimated glomerular filtration rate in HIV-positive individuals in the START trial |
| المؤلفون: |
Achhra, Amit C., Mocroft, Amanda, Ross, Michael, Ryom-Nielson, Lene, Avihingsanon, Anchalee, Bakowska, Elzbieta, Belloso, Waldo, Clarke, Amanda, Furrer, Hansjakob, Lucas, Gregory M., Ristola, Matti, Rassool, Mohammed, Ross, Jonathan, Somboonwit, Charurut, Sharma, Shweta, Wyatt, Christina, INSIGHT START Study Grp |
| المساهمون: |
Clinicum, Department of Medicine, Infektiosairauksien yksikkö, HUS Inflammation Center |
| بيانات النشر: |
Elsevier Scientific Publ. Co |
| سنة النشر: |
2019 |
| المجموعة: |
Helsingfors Universitet: HELDA – Helsingin yliopiston digitaalinen arkisto |
| مصطلحات موضوعية: |
HIV, Kidney, CKD, HAART, eGFR, START, CHRONIC KIDNEY-DISEASE, INFECTED PATIENTS, SERUM CREATININE, TENOFOVIR, RISK, IMMUNODEFICIENCY, NEPHROPATHY, ASSOCIATION, COBICISTAT, VARIANTS, 3121 General medicine, internal medicine and other clinical medicine, 317 Pharmacy, 1183 Plant biology, microbiology, virology |
| الوصف: |
The impact of early ART initiation (versus deferring) on kidney function has not been studied. START was a randomised comparison of immediate versus deferred ART initiation among HIV-positive persons with CD4(+) (cellsimm(3)) counts >500. Serum creatinine and urine dipstick protein were measured at Months 0, 1, 4, 8 and 12, and annually thereafter. The two arms were compared for changes in eGFR (mL/min/1.73 m(2), calculated by CI94% and >19% of follow-up time, respectively. Overall, 89% started ART using a tenofovir-based regimen. Over 2.1 years median follow-up, mean eGFR was 056 (95% CI 0.003-1.11) higher in the immediate versus deferred arm, which was more prominent after adjustment for current tenofovir or bPI use (1.85, 95% CI 1.21-2.50) and in Black participants (30.1% overall) (3.90, 95% CI 2.84-4.97) versus non-Blacks (1.05, 95% CI 0.33-1.77) (P <0.001 for interaction). Relative risk for proteinuria in the immediate versus deferred arm was 0.74 (95% CI 0.55-1.00) (P = 0.049). In the short-term, immediate ART initiation was associated with a modestly higher eGFR and lower proteinuria risk versus deferring ART (more pronounced in Black participants). Whether this early benefit translates into a lower risk of CKD requires further follow-up. (C) 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. ; Peer reviewed |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| العلاقة: |
This work was supported by the National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases [UM1 AI 068641, UM1-A1120197]: the Department of Bioethics at the NIH Clinical Center: the National Cancer Institute: the National Heart, Lung, and Blood Institute; the National Institute of Mental Health; the National Institute of Neurological Disorders and Stroke; and the National Institute of Arthritis and Musculoskeletal Disorders. Financial support for START was also provided by the French Agence Nationale de Recherches sur le SIDA et les Hepatites Virales (ANRS); the Federal Ministry of Education and Research; the European AIDS Treatment Network (NEAT): the National Health and Medical Research Council; and Medical Research Council and National Institute for Health Research. Six pharmaceutical corn panics (AbbVie, Inc., Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline/ViiV Healthcare, Janssen Scientific Affairs, LLC, and Merck Sharp and Dohme Corp.) donate antiretroviral drugs to START. The authors were also supported by the National Institute of Diabetes and Digestive and Kidney Diseases [R01 DK100272, P01 DK056492 and R01 DK112258 to CW] and the National Institute on Drug Abuse [K24 DA035684, R01 DA026770 to GML].; Achhra , A C , Mocroft , A , Ross , M , Ryom-Nielson , L , Avihingsanon , A , Bakowska , E , Belloso , W , Clarke , A , Furrer , H , Lucas , G M , Ristola , M , Rassool , M , Ross , J , Somboonwit , C , Sharma , S , Wyatt , C & INSIGHT START Study Grp 2017 , ' Impact of early versus deferred antiretroviral therapy on estimated glomerular filtration rate in HIV-positive individuals in the START trial ' , International Journal of Antimicrobial Agents , vol. 50 , no. 3 , pp. 453-460 . https://doi.org/10.1016/j.ijantimicag.2017.04.021Test; ORCID: /0000-0001-5115-2811/work/40580735; 85027254683; f31c9579-4d4d-4d2d-a1a6-ae45e335c825; http://hdl.handle.net/10138/298136Test; 000408686800024 |
| الإتاحة: |
http://hdl.handle.net/10138/298136Test |
| حقوق: |
openAccess ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: |
edsbas.2C08DAF9 |
| قاعدة البيانات: |
BASE |
