Kidney Week

Abstract: SA-PO1092

Evaluation of the Effect of Racial Differences on Longitudinal Trajectories of Kidney Function in People with HIV (PWH) on Tenofovir Alafenamide (TAF)-Based Antiretroviral Treatment (ART) Regimens

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Kleinpeter, Myra A., Tulane University School of Medicine, New Orleans, Louisiana, United States

Myra A. Kleinpeter, MD, MPH

• Slim, Jihad, Saint Michael's Medical Center, Newark, New Jersey, United States

Jihad Slim, MD

• Naik, Sarjita, Gilead Sciences Inc, Foster City, California, United States

Sarjita Naik, PharmD, MPH

• Huang, Xiwen, Gilead Sciences Inc, Foster City, California, United States

Xiwen Huang, PhD, MPH

• Weinberg, Amy R., Gilead Sciences Inc, Foster City, California, United States

Amy R. Weinberg, MS, DNP

• Temme, Lauren, Gilead Sciences Inc, Foster City, California, United States

Lauren Temme, PharmD

• Tao, Li, Gilead Sciences Inc, Foster City, California, United States

Li Tao, MD, MS, PhD

• Chokkalingam, Anand, Gilead Sciences Inc, Foster City, California, United States

Anand Chokkalingam, PhD

• Gupta, Samir Kumar, Indiana University School of Medicine, Indianapolis, Indiana, United States

Samir Kumar Gupta, MD

• Chiang, Betty, Gilead Sciences Inc, Foster City, California, United States

Betty Chiang, MD

• Canada, Robert B., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Robert B. Canada, MD

Background

HIV can contribute to chronic kidney disease (CKD), as do some older antiretrovirals. PWH are also subject to traditional risk factors for CKD affecting the general population including but not limited to race, age, and hypertension. Along with variations in prevalence of HIV, racial differences are associated with differences in risk for CKD. We aim to explore the impact of Black race on renal function change in routine clinical practice in a non-CKD population of PWH on TAF-based regimens.

Methods

Individuals with HIV who initiated TAF-based regimens (2015-2023) and had ≥1 estimated glomerular filtration rate (eGFR calculated by CKD-EPI Equation 2021) measurements within 1 year pre- and post-ART initiation were identified using IQVIA Ambulatory EMR-US. Individuals maintained on TAF were followed up until the end of the observation period. eGFR changes were calculated by subtracting post-ART initiation measurements from the pre-initiation 1-year average eGFR and analyzed using a mixed-effects model adjusted for age, sex, and baseline eGFR. Least square means of the adjusted model were plotted.

Results

At baseline, Black (n=1,195) and non-Black PWH (n=1,601) on TAF-based regimens had an average eGFR of 89.9 and 92.4 mL/min. Black PWH were more likely to be female and younger. After adjusting for baseline eGFR and covariates, decline in eGFR at 15 months was -4.5 vs. -2.9 (p>0.05) in Black and non-Black PWH, respectively. The long-term trend became similar between groups at 24 months (Figure). Stratified by baseline eGFR, discrepancies in eGFR changes between groups was mostly driven by baseline eGFR ≥90 mL/min.

Conclusion

Black and non-Black PWH experienced similar changes in eGFR over 24 months of ART including TAF. These results suggest TAF does not increase risk of renal decline in Black PWH.

Funding

• Commercial Support – Gilead Sciences