Impact of early versus deferred antiretroviral therapy on estimated glomerular filtration rate in HIV-positive individuals in the START trial.
Identifieur interne : 004339 ( Ncbi/Merge ); précédent : 004338; suivant : 004340Impact of early versus deferred antiretroviral therapy on estimated glomerular filtration rate in HIV-positive individuals in the START trial.
Auteurs : Amit C. Achhra [États-Unis] ; Amanda Mocroft [Royaume-Uni] ; Michael Ross [États-Unis] ; Lene Ryom-Nielson [Danemark] ; Anchalee Avihingsanon [Thaïlande] ; Elzbieta Bakowska [Pologne] ; Waldo Belloso [Argentine] ; Amanda Clarke [Royaume-Uni] ; Hansjakob Furrer [Suisse] ; Gregory M. Lucas [États-Unis] ; Matti Ristola [Finlande] ; Mohammed Rassool [Afrique du Sud] ; Jonathan Ross [Royaume-Uni] ; Charurut Somboonwit [États-Unis] ; Shweta Sharma [États-Unis] ; Christina Wyatt [Royaume-Uni]Source :
- International journal of antimicrobial agents [ 1872-7913 ] ; 2017.
Abstract
The impact of early ART initiation (versus deferring) on kidney function has not been studied. START was a randomised comparison of immediate versus deferred ART initiation among HIV-positive persons with CD4(+) (cells/mm(3)) counts >500. Serum creatinine and urine dipstick protein were measured at Months 0, 1, 4, 8 and 12, and annually thereafter. The two arms were compared for changes in eGFR (mL/min/1.73 m(2), calculated by CKD-EPI equation), over time using longitudinal mixed models. Of 4685 START participants, 4629 (2294 in immediate and 2335 deferred arm) were included. Median baseline CD4(+) and eGFR were 651 and 111.5, respectively. ART was initiated in 2271 participants (99.0%) in the immediate and 1127 (48.3%) in the deferred arm, accounting for >94% and >19% of follow-up time, respectively. Overall, 89% started ART using a tenofovir-based regimen. Over 2.1 years median follow-up, mean eGFR was 0.56 (95% CI 0.003-1.11) higher in the immediate versus deferred arm, which was more prominent after adjustment for current tenofovir or bPI use (1.85, 95% CI 1.21-2.50) and in Black participants (30.1% overall) (3.90, 95% CI 2.84-4.97) versus non-Blacks (1.05, 95% CI 0.33-1.77) (P < 0.001 for interaction). Relative risk for proteinuria in the immediate versus deferred arm was 0.74 (95% CI 0.55-1.00) (P = 0.049). In the short-term, immediate ART initiation was associated with a modestly higher eGFR and lower proteinuria risk versus deferring ART (more pronounced in Black participants). Whether this early benefit translates into a lower risk of CKD requires further follow-up.
DOI: 10.1016/j.ijantimicag.2017.04.021
PubMed: 28668686
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Impact of early versus deferred antiretroviral therapy on estimated glomerular filtration rate in HIV-positive individuals in the START trial.</title><author><name sortKey="Achhra, Amit C" sort="Achhra, Amit C" uniqKey="Achhra A" first="Amit C" last="Achhra">Amit C. Achhra</name><affiliation wicri:level="2"><nlm:affiliation>Kirby Institute, University of New South Wales, Sydney, NSW, Australia; NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA. Electronic address: aachhra@kirby.unsw.edu.au.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Kirby Institute, University of New South Wales, Sydney, NSW, Australia; NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name><affiliation wicri:level="4"><nlm:affiliation>University College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de 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Clarke</name><affiliation wicri:level="1"><nlm:affiliation>Brighton & Sussex University Hospitals NHS Trust, Brighton, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Brighton & Sussex University Hospitals NHS Trust, Brighton</wicri:regionArea><wicri:noRegion>Brighton</wicri:noRegion></affiliation></author><author><name sortKey="Furrer, Hansjakob" sort="Furrer, Hansjakob" uniqKey="Furrer H" first="Hansjakob" last="Furrer">Hansjakob Furrer</name><affiliation wicri:level="3"><nlm:affiliation>Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Lucas, Gregory M" sort="Lucas, Gregory M" uniqKey="Lucas G" first="Gregory M" last="Lucas">Gregory M. Lucas</name><affiliation wicri:level="2"><nlm:affiliation>School of Medicine, Johns Hopkins University, Baltimore, MD, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>School of Medicine, Johns Hopkins University, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Ristola, Matti" sort="Ristola, Matti" uniqKey="Ristola M" first="Matti" last="Ristola">Matti Ristola</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Division of Infectious Diseases, Helsinki University Hospital, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Rassool, Mohammed" sort="Rassool, Mohammed" uniqKey="Rassool M" first="Mohammed" last="Rassool">Mohammed Rassool</name><affiliation wicri:level="4"><nlm:affiliation>Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Ross, Jonathan" sort="Ross, Jonathan" uniqKey="Ross J" first="Jonathan" last="Ross">Jonathan Ross</name><affiliation wicri:level="3"><nlm:affiliation>University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University Hospital Birmingham NHS Foundation Trust, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Somboonwit, Charurut" sort="Somboonwit, Charurut" uniqKey="Somboonwit C" first="Charurut" last="Somboonwit">Charurut Somboonwit</name><affiliation wicri:level="4"><nlm:affiliation>Moroni College of Medicine, University of South Florida, Tampa, FL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Moroni College of Medicine, University of South Florida, Tampa, FL</wicri:regionArea><placeName><region type="state">Floride</region><settlement type="city">Tampa</settlement></placeName><orgName type="university">Université de Floride du Sud</orgName></affiliation></author><author><name sortKey="Sharma, Shweta" sort="Sharma, Shweta" uniqKey="Sharma S" first="Shweta" last="Sharma">Shweta Sharma</name><affiliation wicri:level="2"><nlm:affiliation>Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Wyatt, Christina" sort="Wyatt, Christina" uniqKey="Wyatt C" first="Christina" last="Wyatt">Christina Wyatt</name><affiliation wicri:level="4"><nlm:affiliation>University College London, London, UK. Electronic address: christina.wyatt@mssm.edu.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28668686</idno><idno type="pmid">28668686</idno><idno type="doi">10.1016/j.ijantimicag.2017.04.021</idno><idno type="wicri:Area/PubMed/Corpus">000E40</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000E40</idno><idno type="wicri:Area/PubMed/Curation">000E40</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000E40</idno><idno type="wicri:Area/PubMed/Checkpoint">000E40</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000E40</idno><idno type="wicri:Area/Ncbi/Merge">004339</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Impact of early versus deferred antiretroviral therapy on estimated glomerular filtration rate in HIV-positive individuals in the START trial.</title><author><name sortKey="Achhra, Amit C" sort="Achhra, Amit C" uniqKey="Achhra A" first="Amit C" last="Achhra">Amit C. Achhra</name><affiliation wicri:level="2"><nlm:affiliation>Kirby Institute, University of New South Wales, Sydney, NSW, Australia; NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA. Electronic address: aachhra@kirby.unsw.edu.au.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Kirby Institute, University of New South Wales, Sydney, NSW, Australia; NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name><affiliation wicri:level="4"><nlm:affiliation>University College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Ross, Michael" sort="Ross, Michael" uniqKey="Ross M" first="Michael" last="Ross">Michael Ross</name><affiliation wicri:level="2"><nlm:affiliation>Icahn School of Medicine at Mount Sinai, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Icahn School of Medicine at Mount Sinai, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Ryom Nielson, Lene" sort="Ryom Nielson, Lene" uniqKey="Ryom Nielson L" first="Lene" last="Ryom-Nielson">Lene Ryom-Nielson</name><affiliation wicri:level="3"><nlm:affiliation>Department of Infectious Diseases, CHIP, Section 8632 Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Infectious Diseases, CHIP, Section 8632 Rigshospitalet, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Avihingsanon, Anchalee" sort="Avihingsanon, Anchalee" uniqKey="Avihingsanon A" first="Anchalee" last="Avihingsanon">Anchalee Avihingsanon</name><affiliation wicri:level="1"><nlm:affiliation>HIV-NAT, Thai Red Cross AIDS Research Centre and Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.</nlm:affiliation><country xml:lang="fr">Thaïlande</country><wicri:regionArea>HIV-NAT, Thai Red Cross AIDS Research Centre and Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok</wicri:regionArea><wicri:noRegion>Bangkok</wicri:noRegion></affiliation></author><author><name sortKey="Bakowska, Elzbieta" sort="Bakowska, Elzbieta" uniqKey="Bakowska E" first="Elzbieta" last="Bakowska">Elzbieta Bakowska</name><affiliation wicri:level="1"><nlm:affiliation>Centrum Diagnostyki i Terapii AIDS, Warsaw, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Centrum Diagnostyki i Terapii AIDS, Warsaw</wicri:regionArea><wicri:noRegion>Warsaw</wicri:noRegion></affiliation></author><author><name sortKey="Belloso, Waldo" sort="Belloso, Waldo" uniqKey="Belloso W" first="Waldo" last="Belloso">Waldo Belloso</name><affiliation wicri:level="1"><nlm:affiliation>Coordinación de Investigación Clínica Académica en Latinoamérica (CICAL) and Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.</nlm:affiliation><country xml:lang="fr">Argentine</country><wicri:regionArea>Coordinación de Investigación Clínica Académica en Latinoamérica (CICAL) and Hospital Italiano de Buenos Aires, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Clarke, Amanda" sort="Clarke, Amanda" uniqKey="Clarke A" first="Amanda" last="Clarke">Amanda Clarke</name><affiliation wicri:level="1"><nlm:affiliation>Brighton & Sussex University Hospitals NHS Trust, Brighton, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Brighton & Sussex University Hospitals NHS Trust, Brighton</wicri:regionArea><wicri:noRegion>Brighton</wicri:noRegion></affiliation></author><author><name sortKey="Furrer, Hansjakob" sort="Furrer, Hansjakob" uniqKey="Furrer H" first="Hansjakob" last="Furrer">Hansjakob Furrer</name><affiliation wicri:level="3"><nlm:affiliation>Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Lucas, Gregory M" sort="Lucas, Gregory M" uniqKey="Lucas G" first="Gregory M" last="Lucas">Gregory M. Lucas</name><affiliation wicri:level="2"><nlm:affiliation>School of Medicine, Johns Hopkins University, Baltimore, MD, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>School of Medicine, Johns Hopkins University, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Ristola, Matti" sort="Ristola, Matti" uniqKey="Ristola M" first="Matti" last="Ristola">Matti Ristola</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Division of Infectious Diseases, Helsinki University Hospital, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Rassool, Mohammed" sort="Rassool, Mohammed" uniqKey="Rassool M" first="Mohammed" last="Rassool">Mohammed Rassool</name><affiliation wicri:level="4"><nlm:affiliation>Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Ross, Jonathan" sort="Ross, Jonathan" uniqKey="Ross J" first="Jonathan" last="Ross">Jonathan Ross</name><affiliation wicri:level="3"><nlm:affiliation>University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University Hospital Birmingham NHS Foundation Trust, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Somboonwit, Charurut" sort="Somboonwit, Charurut" uniqKey="Somboonwit C" first="Charurut" last="Somboonwit">Charurut Somboonwit</name><affiliation wicri:level="4"><nlm:affiliation>Moroni College of Medicine, University of South Florida, Tampa, FL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Moroni College of Medicine, University of South Florida, Tampa, FL</wicri:regionArea><placeName><region type="state">Floride</region><settlement type="city">Tampa</settlement></placeName><orgName type="university">Université de Floride du Sud</orgName></affiliation></author><author><name sortKey="Sharma, Shweta" sort="Sharma, Shweta" uniqKey="Sharma S" first="Shweta" last="Sharma">Shweta Sharma</name><affiliation wicri:level="2"><nlm:affiliation>Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Wyatt, Christina" sort="Wyatt, Christina" uniqKey="Wyatt C" first="Christina" last="Wyatt">Christina Wyatt</name><affiliation wicri:level="4"><nlm:affiliation>University College London, London, UK. Electronic address: christina.wyatt@mssm.edu.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author></analytic><series><title level="j">International journal of antimicrobial agents</title><idno type="eISSN">1872-7913</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The impact of early ART initiation (versus deferring) on kidney function has not been studied. START was a randomised comparison of immediate versus deferred ART initiation among HIV-positive persons with CD4(+) (cells/mm(3)) counts >500. Serum creatinine and urine dipstick protein were measured at Months 0, 1, 4, 8 and 12, and annually thereafter. The two arms were compared for changes in eGFR (mL/min/1.73 m(2), calculated by CKD-EPI equation), over time using longitudinal mixed models. Of 4685 START participants, 4629 (2294 in immediate and 2335 deferred arm) were included. Median baseline CD4(+) and eGFR were 651 and 111.5, respectively. ART was initiated in 2271 participants (99.0%) in the immediate and 1127 (48.3%) in the deferred arm, accounting for >94% and >19% of follow-up time, respectively. Overall, 89% started ART using a tenofovir-based regimen. Over 2.1 years median follow-up, mean eGFR was 0.56 (95% CI 0.003-1.11) higher in the immediate versus deferred arm, which was more prominent after adjustment for current tenofovir or bPI use (1.85, 95% CI 1.21-2.50) and in Black participants (30.1% overall) (3.90, 95% CI 2.84-4.97) versus non-Blacks (1.05, 95% CI 0.33-1.77) (P < 0.001 for interaction). Relative risk for proteinuria in the immediate versus deferred arm was 0.74 (95% CI 0.55-1.00) (P = 0.049). In the short-term, immediate ART initiation was associated with a modestly higher eGFR and lower proteinuria risk versus deferring ART (more pronounced in Black participants). Whether this early benefit translates into a lower risk of CKD requires further follow-up.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28668686</PMID><DateCreated><Year>2017</Year><Month>07</Month><Day>02</Day></DateCreated><DateRevised><Year>2017</Year><Month>09</Month><Day>05</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1872-7913</ISSN><JournalIssue CitedMedium="Internet"><Volume>50</Volume><Issue>3</Issue><PubDate><Year>2017</Year><Month>Sep</Month></PubDate></JournalIssue><Title>International journal of antimicrobial agents</Title><ISOAbbreviation>Int. J. Antimicrob. Agents</ISOAbbreviation></Journal><ArticleTitle>Impact of early versus deferred antiretroviral therapy on estimated glomerular filtration rate in HIV-positive individuals in the START trial.</ArticleTitle><Pagination><MedlinePgn>453-460</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0924-8579(17)30230-3</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijantimicag.2017.04.021</ELocationID><Abstract><AbstractText>The impact of early ART initiation (versus deferring) on kidney function has not been studied. START was a randomised comparison of immediate versus deferred ART initiation among HIV-positive persons with CD4(+) (cells/mm(3)) counts >500. Serum creatinine and urine dipstick protein were measured at Months 0, 1, 4, 8 and 12, and annually thereafter. The two arms were compared for changes in eGFR (mL/min/1.73 m(2), calculated by CKD-EPI equation), over time using longitudinal mixed models. Of 4685 START participants, 4629 (2294 in immediate and 2335 deferred arm) were included. Median baseline CD4(+) and eGFR were 651 and 111.5, respectively. ART was initiated in 2271 participants (99.0%) in the immediate and 1127 (48.3%) in the deferred arm, accounting for >94% and >19% of follow-up time, respectively. Overall, 89% started ART using a tenofovir-based regimen. Over 2.1 years median follow-up, mean eGFR was 0.56 (95% CI 0.003-1.11) higher in the immediate versus deferred arm, which was more prominent after adjustment for current tenofovir or bPI use (1.85, 95% CI 1.21-2.50) and in Black participants (30.1% overall) (3.90, 95% CI 2.84-4.97) versus non-Blacks (1.05, 95% CI 0.33-1.77) (P < 0.001 for interaction). Relative risk for proteinuria in the immediate versus deferred arm was 0.74 (95% CI 0.55-1.00) (P = 0.049). In the short-term, immediate ART initiation was associated with a modestly higher eGFR and lower proteinuria risk versus deferring ART (more pronounced in Black participants). Whether this early benefit translates into a lower risk of CKD requires further follow-up.</AbstractText><CopyrightInformation>Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Achhra</LastName><ForeName>Amit C</ForeName><Initials>AC</Initials><AffiliationInfo><Affiliation>Kirby Institute, University of New South Wales, Sydney, NSW, Australia; NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA. Electronic address: aachhra@kirby.unsw.edu.au.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mocroft</LastName><ForeName>Amanda</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>University College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ross</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Icahn School of Medicine at Mount Sinai, New York, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ryom-Nielson</LastName><ForeName>Lene</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, CHIP, Section 8632 Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Avihingsanon</LastName><ForeName>Anchalee</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>HIV-NAT, Thai Red Cross AIDS Research Centre and Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bakowska</LastName><ForeName>Elzbieta</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Centrum Diagnostyki i Terapii AIDS, Warsaw, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Belloso</LastName><ForeName>Waldo</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Coordinación de Investigación Clínica Académica en Latinoamérica (CICAL) and Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clarke</LastName><ForeName>Amanda</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Brighton & Sussex University Hospitals NHS Trust, Brighton, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Furrer</LastName><ForeName>Hansjakob</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lucas</LastName><ForeName>Gregory M</ForeName><Initials>GM</Initials><AffiliationInfo><Affiliation>School of Medicine, Johns Hopkins University, Baltimore, MD, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ristola</LastName><ForeName>Matti</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rassool</LastName><ForeName>Mohammed</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ross</LastName><ForeName>Jonathan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Somboonwit</LastName><ForeName>Charurut</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Moroni College of Medicine, University of South Florida, Tampa, FL, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sharma</LastName><ForeName>Shweta</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wyatt</LastName><ForeName>Christina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>University College London, London, UK. Electronic address: christina.wyatt@mssm.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>K24 DA035684</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 DK100272</GrantID><Acronym>DK</Acronym><Agency>NIDDK NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>UM1 AI120197</GrantID><Acronym>AI</Acronym><Agency>NIAID NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 DA026770</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>UM1 AI068641</GrantID><Acronym>AI</Acronym><Agency>NIAID NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>P01 DK056492</GrantID><Acronym>DK</Acronym><Agency>NIDDK NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 DK112258</GrantID><Acronym>DK</Acronym><Agency>NIDDK NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>06</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Int J Antimicrob Agents</MedlineTA><NlmUniqueID>9111860</NlmUniqueID><ISSNLinking>0924-8579</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>HIV Med. 2015 Apr;16 Suppl 1:55-63</RefSource><PMID Version="1">25711324</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2014 Mar 20;9(3):e92717</RefSource><PMID Version="1">24651857</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Am Soc Nephrol. 2011 Nov;22(11):2129-37</RefSource><PMID Version="1">21997394</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet HIV. 2015 Jul;2(7):e288-98</RefSource><PMID Version="1">26423253</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2009 Oct 23;23(16):2143-9</RefSource><PMID Version="1">19684507</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>N Engl J Med. 2015 Aug 27;373(9):795-807</RefSource><PMID Version="1">26192873</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>JAMA. 2010 Mar 24;303(12):1180-7</RefSource><PMID Version="1">20332404</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Nephrol. 2014;2014:381985</RefSource><PMID Version="1">24800076</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Kidney Int. 2014 Aug;86(2):350-7</RefSource><PMID Version="1">24646860</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2016 May 12;11(5):e0155100</RefSource><PMID Version="1">27171281</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Ann Intern Med. 1999 Mar 16;130(6):461-70</RefSource><PMID Version="1">10075613</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Ann Intern Med. 2009 May 5;150(9):604-12</RefSource><PMID Version="1">19414839</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2010 Jun 12;375(9731):2073-81</RefSource><PMID Version="1">20483451</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2009 Mar 27;23(6):689-96</RefSource><PMID Version="1">19262355</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2010 Jul 31;24(12):1877-86</RefSource><PMID Version="1">20588170</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2015 Jun 27;385(9987):2606-15</RefSource><PMID Version="1">25890673</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Clin Infect Dis. 2003 Apr 15;36(8):1070-3</RefSource><PMID Version="1">12684922</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Curr Opin HIV AIDS. 2014 Jan;9(1):41-7</RefSource><PMID Version="1">24225381</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Clin Infect Dis. 2014 Nov 1;59(9):e96-138</RefSource><PMID Version="1">25234519</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS Med. 2015 Mar 31;12(3):e1001809</RefSource><PMID Version="1">25826420</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Pediatr Nephrol. 2015 Feb;30(2):193-8</RefSource><PMID Version="1">25370779</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Curr HIV/AIDS Rep. 2016 Jun;13(3):149-57</RefSource><PMID Version="1">27130284</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet HIV. 2016 Jan;3(1):e23-32</RefSource><PMID Version="1">26762990</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Am Soc Nephrol. 2011 Nov;22(11):1991-6</RefSource><PMID Version="1">21997397</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2012 Apr 24;26(7):867-75</RefSource><PMID Version="1">22313955</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2011 Nov 13;25(17):2149-55</RefSource><PMID Version="1">21857491</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2014 Sep 1;67(1):36-44</RefSource><PMID Version="1">25117929</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">CKD</Keyword><Keyword MajorTopicYN="N">HAART</Keyword><Keyword MajorTopicYN="N">HIV</Keyword><Keyword MajorTopicYN="N">Kidney</Keyword><Keyword MajorTopicYN="N">START</Keyword><Keyword MajorTopicYN="N">eGFR</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>12</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2017</Year><Month>04</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>04</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="pmc-release"><Year>2018</Year><Month>09</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>7</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>7</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>7</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28668686</ArticleId><ArticleId IdType="pii">S0924-8579(17)30230-3</ArticleId><ArticleId IdType="doi">10.1016/j.ijantimicag.2017.04.021</ArticleId><ArticleId IdType="pmc">PMC5581703</ArticleId><ArticleId IdType="mid">NIHMS888880</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Afrique du Sud</li><li>Argentine</li><li>Danemark</li><li>Finlande</li><li>Pologne</li><li>Royaume-Uni</li><li>Suisse</li><li>Thaïlande</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Canton de Berne</li><li>Floride</li><li>Gauteng</li><li>Grand Londres</li><li>Hovedstaden</li><li>Maryland</li><li>Midlands de l'Ouest</li><li>Minnesota</li><li>État de New York</li></region><settlement><li>Berne</li><li>Birmingham</li><li>Copenhague</li><li>Johannesbourg</li><li>Londres</li><li>Tampa</li></settlement><orgName><li>University College de Londres</li><li>Université de Floride du Sud</li><li>Université du Witwatersrand</li></orgName></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Achhra, Amit C" sort="Achhra, Amit C" uniqKey="Achhra A" first="Amit C" last="Achhra">Amit C. 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Lucas</name><name sortKey="Ross, Michael" sort="Ross, Michael" uniqKey="Ross M" first="Michael" last="Ross">Michael Ross</name><name sortKey="Sharma, Shweta" sort="Sharma, Shweta" uniqKey="Sharma S" first="Shweta" last="Sharma">Shweta Sharma</name><name sortKey="Somboonwit, Charurut" sort="Somboonwit, Charurut" uniqKey="Somboonwit C" first="Charurut" last="Somboonwit">Charurut Somboonwit</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name></region><name sortKey="Clarke, Amanda" sort="Clarke, Amanda" uniqKey="Clarke A" first="Amanda" last="Clarke">Amanda Clarke</name><name sortKey="Ross, Jonathan" sort="Ross, Jonathan" uniqKey="Ross J" first="Jonathan" last="Ross">Jonathan Ross</name><name sortKey="Wyatt, Christina" sort="Wyatt, Christina" uniqKey="Wyatt C" first="Christina" last="Wyatt">Christina Wyatt</name></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Ryom Nielson, Lene" sort="Ryom Nielson, Lene" uniqKey="Ryom Nielson L" first="Lene" last="Ryom-Nielson">Lene Ryom-Nielson</name></region></country><country name="Thaïlande"><noRegion><name sortKey="Avihingsanon, Anchalee" sort="Avihingsanon, Anchalee" uniqKey="Avihingsanon A" first="Anchalee" last="Avihingsanon">Anchalee Avihingsanon</name></noRegion></country><country name="Pologne"><noRegion><name sortKey="Bakowska, Elzbieta" sort="Bakowska, Elzbieta" uniqKey="Bakowska E" first="Elzbieta" last="Bakowska">Elzbieta Bakowska</name></noRegion></country><country name="Argentine"><noRegion><name sortKey="Belloso, Waldo" sort="Belloso, Waldo" uniqKey="Belloso W" first="Waldo" last="Belloso">Waldo Belloso</name></noRegion></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Furrer, Hansjakob" sort="Furrer, Hansjakob" uniqKey="Furrer H" first="Hansjakob" last="Furrer">Hansjakob Furrer</name></region></country><country name="Finlande"><noRegion><name sortKey="Ristola, Matti" sort="Ristola, Matti" uniqKey="Ristola M" first="Matti" last="Ristola">Matti Ristola</name></noRegion></country><country name="Afrique du Sud"><region name="Gauteng"><name sortKey="Rassool, Mohammed" sort="Rassool, Mohammed" uniqKey="Rassool M" first="Mohammed" last="Rassool">Mohammed Rassool</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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