Comparative study of serum creatinine levels and renal function in HIV-infected patients before and after switching to a regimen containing Dolutegravir and Tenofovir disoproxil fumarate in ARV clinic at Chaiyaphum Hospital

Abstract

            This cross-sectional study aimed to compare serum creatinine levels and glomerular filtration rates (GFR) in HIV patients receiving antiretroviral therapy (ART) regimens containing Dolutegravir (DTG) and Tenofovir disoproxil fumarate (TDF).

            A total of 252 patients from Chaiyaphum Hospital's antiretroviral clinic were included between 2022 and 2024.  Patients were divided into two groups: those receiving TDF with Efavirenz or Nevirapine (Group 1, n=180) and those receiving TDF with Atazanavir/ritonavir or Lopinavir/ritonavir (Group 2, n=72).  Data were analyzed using t-tests, Mann Whitney U tests, Wilcoxon signed rank tests, and multiple logistic regression.

            After 4.0 months of switching to regimens containing DTG and TDF, both groups showed significant increases in creatinine levels and decreases in eGFR (p<0.001). Group 1 experienced more significant changes compared to Group 2 (p<0.05). Additionally, 29.4% of patients developed nephrotoxicity, with baseline eGFR being a significant risk factor (adjusted OR=1.03; 95%CI: 1.01, 1.05).

            Conclusion and Recommendations: Switching to DTG and TDF regimens affects renal function, with those previously on Efavirenz or Nevirapine regimens experiencing greater impacts. Close monitoring of renal function is recommended, and further research on other risk factors is suggested to develop effective management strategies for HIV treatment and reduce the risk of renal complications in the future.