Background: India has the third highest number of estimated people living with human immunodeficiency virus (HIV) in the world. Tenofovir (TDF) is an effective and widely used drug in treatment for both HIV and hepatitis B virus infection. Tenofovir is widely used in combination antiretroviral therapy including as a fixed dose combination pill. Several case reports and case series reported afterwards found tenofovir to be associated with nephropathy.

Aim: To study the incidence of tenofovir related nephropathies in HIV infected patients and to study the correlation of tenofovir induced nephrotoxicity with CD4 count.

Material and Methods: 200 patients on TDF based Antiretroviral therapy (ART) were included in hospital based prospective study based on inclusion and exclusion criteria. Baseline study variables serum creatinine value, urine-routine and microscopy, 24 hour urinary protein and CD4 count were recorded and patients were followed up for 6 months and study variables were compared. Statistical analysis were done by SPSS version 22.1.

Results: All patients had normal baseline renal function and urine routine and microscopic examination and were on tenofovir containing ART regimen. Mean age was 36.86 years and Sex ratio was 1.38:1. After six months of therapy 26 patients (13%) developed proteinuria. 20 patients (10%) had +1 proteinuria, 5 patients (2.5%) had +2 proteinuria and 1 patient (0.5%) had +3 proteinuria. Total 147 patients (73.5%) had weight gain and 53 patients (26.5%) had weight loss after taking tenofovir based ART for 6 months. Improvement in CD4 count was seen in 88.5% patients. Improvement in CD4 count was seen in 21 out of 26 patients having proteinuria. Decline in CD4 count was seen in total 11.5% patients. In this study, 12.5% patients had increase in creatinine levels and decrease in creatinine clearance was found in 13% patients.

Conclusion: Use of tenofovir based ART regimen is associated with increased incidence of nephropathy despite improvement in CD4 count and body weight significantly.

Keywords: Tenofovir, Nephropathy, HIV, CD4, ART.

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Dr Jitendra Kumar Doneria

Lecturer, P.G. Department of Medicine,

S.N. Medical College, Agra, Uttar Pradesh, India

Phone (or Mobile) No.: +91-8979387751, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.