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The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland
Dissertation (MSc)--University of Pretoria, 2018.
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| Format: | Thesis |
| Language: | English |
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University of Pretoria
2019
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| _version_ | 1867613580189237248 |
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| access_status_str | Open Access |
| author2 | Ledibane, N.R.T. |
| author_browse | Ledibane, N.R.T. |
| author_facet | Ledibane, N.R.T. |
| collection | Thesis |
| dc_rights_str_mv | © 2019 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
| description | Dissertation (MSc)--University of Pretoria, 2018. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/70081 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:38:24.243Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/70081 The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland Ledibane, N.R.T. sdlamininqeketo@gmail.com Takuva, Simbarashe G. Dlamini, Sithembile UCTD Tenofovir Antiretroviral Therapy HIV Infection Nephrotoxicity Renal Failure Health sciences theses SDG-03 Health sciences theses SDG-10 Health sciences theses SDG-17 Dissertation (MSc)--University of Pretoria, 2018. Background: Tenofovir (TDF) forms part of the backbone of first and second line HIV infection management. There is limited data from resource-constrained settings on nephrotoxic adverse effects of Tenofovir based antiretroviral therapy (ART). Objective: We investigated the incidence and risk factors of TDF-associated nephrotoxicity in a cohort of HIV-infected patients on either TDF or Zidovudine (AZT) based first line ART. Methods: A retrospective analysis was conducted on a sample of participants initiated on first-line TDF- and Zidovudine (AZT)-based regimens between January 2010 and December 2015; from the national ART electronic database of Mbabane Government and Raleigh Fitkins Memorial hospitals in Swaziland. Time-to-onset of toxicity was assessed using Kaplan-Meier survival analysis and the log rank test was used to compare renal dysfunction by TDF or AZT first line regimen status. Toxicity incidence rate was calculated and multivariate Cox regression model was used to identify the potential risk factors. Main Findings: A total of 1,119 participants with median age 36 years (IQR: 18 to 79 years), were included in the analysis 83% (n=929) on TDF and 17% on AZT (n=190). The median time to onset of toxicity was 6.72 months (IQR: 0.03 to 81.61). The overall incidence rate was 8.08 per 1000 person-months. TDF-associated nephrotoxicity was 9.44 per 1000 person-months (95% CI: 7.79 to 11.44) and 4.83 per 1000 person-months (95% CI: 3.18 to 7.33) for AZT. Participants on TDF-based regimen were more likely to develop toxicity in comparison to AZT, hazard ratio 2.08 (95% CI: 1.27 to 3.40, p=0.003). The mean CD4 count was 194 cells/_L (95% CI: 207.61 to 228.75), and mean eGFR was 123.56, (95% CI: 121.22 to 125.92). The co-variates: sex, age, WHO clinical staging, body mass index and CD4 cell count were not associated with developing nephrotoxicity (p>0.05). Conclusion: Although TDF is effective in HIV management, it is associated with a two-fold increased risk of abnormal renal function during the follow-up period compared to those on AZT. This underlines the paramount importance of regular record-keeping for thorough pharmacovigilance and routine surveillance due to its wide usage. em2026 School of Health Systems and Public Health (SHSPH) MSc Unrestricted SDG-03: Good health and well-being SDG-10: Reduced inequalities SDG-17: Partnerships for the goals 2019-06-02T11:40:01Z 2019-06-02T11:40:01Z 2019/04/26 2018 Dissertation Dlamini, S 2018, The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland, MSc Dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/70081> A2019 http://hdl.handle.net/2263/70081 en © 2019 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria |
| spellingShingle | UCTD Tenofovir Antiretroviral Therapy HIV Infection Nephrotoxicity Renal Failure Health sciences theses SDG-03 Health sciences theses SDG-10 Health sciences theses SDG-17 The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland |
| title | The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland |
| title_full | The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland |
| title_fullStr | The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland |
| title_full_unstemmed | The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland |
| title_short | The epidemiology of Tenofovir-associated renal failure in patients on antiretroviral therapy in Swaziland |
| title_sort | epidemiology of tenofovir associated renal failure in patients on antiretroviral therapy in swaziland |
| topic | UCTD Tenofovir Antiretroviral Therapy HIV Infection Nephrotoxicity Renal Failure Health sciences theses SDG-03 Health sciences theses SDG-10 Health sciences theses SDG-17 |
| url | http://hdl.handle.net/2263/70081 |