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Use of Contemporary Protease Inhibitors and Risk of Incident Chronic Kidney Disease in Persons With Human Immunodeficiency Virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study.

  • Ryom, Lene1
  • Dilling Lundgren, Jens1
  • Reiss, Peter2, 3
  • Kirk, Ole1
  • Law, Matthew4
  • Ross, Mike5
  • Morlat, Phillip6
  • Andreas Fux, Christoph7
  • Fontas, Eric8
  • De Wit, Stephane9
  • D'Arminio Monforte, Antonella10
  • El-Sadr, Wafaa11
  • Phillips, Andrew12
  • Ingrid Hatleberg, Camilla1
  • Sabin, Caroline12
  • Mocroft, Amanda12
  • 1 Rigshospitalet, University of Copenhagen, CHIP, Department of Infectious Diseases, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen, Denmark. , (Denmark)
  • 2 Amsterdam University Medical Centres (Location AMC), Department of Global Health and Division of Infectious Diseases, University of Amsterdam.
  • 3 HIV Monitoring Foundation, Amsterdam, The Netherlands. , (Netherlands)
  • 4 Kirby Institute, University of New South Wales Sydney, Australia. , (Australia)
  • 5 Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, and.
  • 6 Université de Bordeaux, INSERM.
  • 7 Clinic for Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland. , (Switzerland)
  • 8 Department of Public Health, Nice University Hospital, France. , (France)
  • 9 Division of Infectious Diseases, Saint Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium. , (Belgium)
  • 10 Dipartimento di Scienze della Salute, Clinica di Malattie Infettive e Tropicali, Azienda Ospedaliera-Polo Universitario San Paolo, Milan, Italy. , (Italy)
  • 11 ICAP at Columbia University and Harlem Hospital, New York.
  • 12 Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London, London, United Kingdom. , (United Kingdom)
Published Article
The Journal of Infectious Diseases
Oxford University Press
Publication Date
Oct 08, 2019
DOI: 10.1093/infdis/jiz369
PMID: 31504669


It is unclear whether use of contemporary protease inhibitors pose a similar risk of chronic kidney disease (CKD) as use of older protease inhibitors. Participants in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were followed up until the earliest occurrence of CKD, the last visit plus 6 months, or 1 February 2016. Adjusted Poisson regression was used to assess associations between CKD and the use of ritonavir-boosted atazanavir (ATV/r) or ritonavir-boosted darunavir (DRV/r). The incidence of CKD (10.0/1000 person-years of follow-up; 95% confidence interval, 9.5-10.4/1000 person-years of follow-up) increased gradually with increasing exposure to ATV/r, but the relation was less clear for DRV/r. After adjustment, only exposure to ATV/r (adjusted incidence rate ratio, 1.4; 95% confidence interval, 1.2-1.6), but not exposure to DRV/r (1.0; .8-1.3), remained significantly associated with CKD. While DRV/r use was not significantly associated with CKD an increasing incidence with longer ATV/r use was confirmed. © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected]

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