Improvements in HIV treatment and care mean that the outlook for many people living with HIV is now extremely good, with expected lifespans approaching normal. Non-AIDS-related diseases are an increasingly important cause of serious illness in people with HIV, and one such cause is chronic kidney disease. The exact reasons for the elevated rates of renal dysfunction observed in people living with HIV are unclear. However, there is increasing evidence suggesting that certain antiretroviral drugs may play a role. Data from a large study into the safety of anti-HIV drugs suggest that the antiretrovirals tenofovir (Viread, also in Truvada, Atripla and Eviplera), atazanavir (Reyataz) and lopinavir/ritonavir (Kaletra) each have an independent association with a decline in kidney function. Results also suggest that kidney function improved after therapy with these drugs was stopped. The authors stress the importance of monitoring the renal health of people treated with anti-HIV drugs regularly, and that physicians should keep an open mind about the potential causes of kidney problems.
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