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Kidney Issues on HIV Treatment (Truvada + Prezista)
Apr 7, 2010

Hello Doctor,

I have a question about what I should do about my HIV treatment with sudden kidney issues.

History: on meds (prezista+norvir+truvada) since 2008, viral load is undetectable, CD4 at 700-800, % at 25. recently, i got my labs back and it showed issues with my kidneys (eGFR 58; am white male), and my doc repeated it twice, and it showed the same. I've never had kidney issues in my life.

My doc is talking about switching drugs. He suspects the Viread in the Truvada (fyi: I am also on Testosterone Cypionate 1.5 mL/2 weeks IM, and Famvir 2x day).

Are there regimens that are just as effective without Viread that aren't hard on the kidneys? What ones do you recommend when kidney issues arise?

I don't want to change medicines, but at the same time, I realize that my kidneys are essential...ha...could the kidney issues be caused by the Famvir or Testosterone?

Thanks for all your advice Doctor.

W.

Response from Dr. Henry

You may also want to discussing with your HIV specialist checking for protein, microalbumin in urine, levels of phosphorus in urine/blood, and other tests to determine fully status of renal function. Often a referral to renal specialist to look for other causes is worthwhile before making a decision about switching meds around. Often the doses of tenofovir and FTC can be adjusted in the setting of mild renal impairment or switched to alternative (such as using abacavir or AZT or others)if renal impairment severe or worsening with determination that tenofovir is worsening or contributing to that situation. There are other good regimens available if the tenofovir needs to be stopped. KH



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