CP-026 Renal safety of tenofovir and cobicistat

BackgroundThe antiretroviral combination tenofovir disoproxil, emtricitabine, cobicistat and elvitegravir (TDF/FTC/COBI/RVG) has been widely used to treat HIV infection. This regimen is related to the highest risk of kidney disease because of the ability of cobicistat to block creatinine tubular secretion, boosting tenofovir’s nephrotoxic effect because this drug is cleared using the same mechanism. Hence careful monitoring of creatinine clearance, urine glucose and protein levels, and blood phosphate levels at the start and during treatment is key.PurposeTo assess the impact of TDF/FTC/COBI/RVG on renal function in our patients, evaluating the extent to which EPAR’s monitoring needs are satisfied at the start and during treatment, and describing measures taken to resolve any incidences encountered.Material and methodsWe undertook a descriptive retrospective study, involving all patients treated with TDF/FTC/COBI/EVG over 2 years. Data were collected from patients’ digital clinical and analytical histories. We registered demographic data, previous treatments with tenofovir or cobicistat, laboratory monitoring information, adjustment of monitoring to given criteria, use of other nephrotoxic drugs and measures taken if renal function decreased (if ClCr