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JAC Advance Access published online on March 21, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm064
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

No change in calculated creatinine clearance after tenofovir initiation among Thai patients

Angele Gayet-Ageron1,*, Jintanat Ananworanich2, Thidarat Jupimai2, Ploenchan Chetchotisakd3, Wisit Prasithsirikul4, Sasiwimol Ubolyam2, Michelle Le Braz1, Kiat Ruxrungtham2,5, James F. Rooney6, Bernard Hirschel on behalf of the Staccato Study Group1,{dagger}

1 University Hospital of Geneva, Geneva, Switzerland 2 The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Bangkok, Thailand 3 Khon Kaen University, Srinagarind Hospital, Khon Kaen, Thailand 4 Bamrasnaradura Institute, Nonthaburi, Thailand 5 Chulalongkorn University, Bangkok, Thailand 6 Gilead Sciences, Foster City, CA, USA

Received 9 October 2006; returned 18 December 2006; revised 23 January 2007; accepted 13 February 2007

* Correspondence address. Division of Infectious Diseases, Geneva University Hospital, CH-1211 Geneva 14, Switzerland. Tel: +41-22-372-9812; E-mail: angele.gayet-ageron{at}hcuge.ch

Objectives: Thai patients have a lower average body weight than patients from western Europe or the USA. Tenofovir is largely prescribed at the standard dosage of 300 mg once daily: therefore, the per kilogram dose is higher in Thailand than in the USA. We asked the question whether this higher per kilogram dose was associated with more nephrotoxicity.

Methods: Thai patients from the Staccato trial were treated with tenofovir/lamivudine combined with ritonavir-boosted saquinavir. Creatinine values were measured before the start of tenofovir and then every 12 weeks. Renal function was assessed using the Cockcroft–Gault formula and the MDRD formula. To compare CLCR before and after tenofovir, the t-paired or Wilcoxon signed rank tests were used. One-way analysis of variance and Spearman's correlation coefficient were used to study CLCR longitudinally.

Results: CLCR remained stable after a median of 21 weeks on tenofovir (difference of +1.06 mL/min; 95% CI –2.7–4.8, P = 0.58), even among patients with underlying diseases. The mean CLCR remained stable across time (P = 0.17).

Conclusions: We did not find renal dysfunction on tenofovir among Thai patients included in the Staccato trial. Tenofovir could be safely prescribed at a standard dosage of 300 mg once daily in the Thai population.

Key Words: antivirals , HIV/AIDS , safety , tolerance , nucleotide analogues , combination treatment , toxicity

{dagger} Members are listed in the Acknowledgements section.


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