Comparison of Renal Function Biomarkers of Serum Creatinine and Cystatin C in HIV-Infected People on Dolutegravir-Containing Therapy

Figures & data

Table 1 Baseline Characteristics of These Patients Among Four Groups

Variables	Combined DTG and TDF(n=37) Group1	DTG Without TDF(n=23) Group 2	TDF Without DTG(n=47) Group 3	Switch-to DTG(n=31) Group 4	P-Value†	P-Value‡
Age, mean years	38.9±12.6	40.2±15.7	34.3±9.2	34.8±8.1	0.128	0.803
Male, n(%)	35(94.6)	23(100)	44(93.6)	29(93.5)	0.714	0.677
Route of transmission, n(%)
Homosexual	23(62.2)	17(73.9)	35(74.5)	16(51.6)	0.784	0.017
Heterosexual	6(16.2)	2(8.7)	5(10.6)	2(6.5)
Blood	0(0.0)	0(0.0)	0(0.0)	4(12.9)
Unclear/others	8(21.6)	4(17.4)	7(14.9)	9(29.0)
Viral load (lg copies/mL)	5.16±0.77	4.76±0.68	4.80±0.80	4.66±0.67	0.007	0.423
CD4+T cell(cell/ul)	192(78,344)	372(183,631)	257(118,467)	304(194,417)	0.004	0.672
Opportunistic infection,	12(32.4)	8(34.8)	5(10.6)	7(22.6)	0.018	0.068
n(%)
HBsAg(+),n(%)	2(5.4)	0(0.0)	3(6.4)	1(3.2)	0.714	0.648
HCV-Ab(+),n(%)	2(5.4)	0(0.0)	0(0.0)	2(6.5)	0.215	0.059
Type 2 Diabetes, n(%)	5(13.5)	1(4.3)	2(4.3)	5(16.1)	0.252	0.107
Hypertension, n(%)	5(13.5)	2(8.7)	2(4.3)	1(3.2)	0.355	0.654
Initial ART regimen, n(%)	NA	NA
2NRTIs + NNRTI			47(100)	12(38.7)
2NRTIs+PI				7(22.5)	NA	NA
2NRTIs + INSTI				10(32.3)
Other				2(6.5)
Nephrotoxic drug, n(%)	9(24.3)	3(13.0)	15(31.9)	4(12.9)	0.419	0.255
Weight(kg)	66.6±8.20	66.4±14.16	70.8±7.65	67.6±1.84	0.892	0.127
Urine test abnormality, n(%)	3(8.1)	1(4.3)	3(6.4)	2(6.5)	0.895	0.648
Baseline serum creatine(umol/L)	75.5±13.4	77.2±12.4	77.1±10.7	82.9±12.9	0.806	0.062
Baseline Cystatin C(mg/L)	1.01±0.21	1.16±0.34	0.99±0.29	0.86±0.14	0.255	0.102
Baseline eGFRcr(ml/min per 1.73 m2)	107.7±12.7	105.3±13.9	114.5±17.1	106.3±18.7	0.070	0.051
Baseline eGFRCysc(ml/min per 1.73 m2)	87.09±23.6	77.3±31.5	93.2±27.4	104.9±18.5	0.368	0.128

Notes: P-value^†: comparison among group 1 and 2 and 3; P-value^‡: comparison between group 3 and 4.

Abbreviations: HBsAg(+), HBV-S antigen positive; HCV-Ab(+), HCV antibody positive; NRTIs, nucleoside reverse-transcriptase inhibitors; NNRTI, non-nucleoside reverse-transcriptase inhibitors; PI, proteinase inhibitor; INSTI, integrase inhibitor; NA, not acquired; eGFRcr, estimating glomerular filtration rate based on creatinine; eGFR_Cysc, estimating glomerular filtration rate based on cystatin C.

Figure 1 The dynamics of serum creatinine and eGFR_cr among four groups (** <0.01,***<0.001; ns: not significant). (A, C, E and G) showed the mean level of serum creatinine from baseline to 48w. (B, D, F and H) showed the mean estimating glomerular filtration rate based on serum creatinine, and the equation used CKD-EPI, was expressed as equation depicted above.

Figure 2 The dynamic of CysC and eGFR_CysC among four groups (* <0.05; ** <0.01,***<0.001; ns: not significant). (A, C, E and G) showed the mean level of cystatin C from baseline to 48w. (B, D, F and H) showed the mean estimating glomerular filtration rate based on cystatin C, and the equation used CKD-EPI, was expressed as equation depicted above.

Figure 3 Bland–Altman of consistency between eGFR_cr and eGFR_CysC among DTG-treatment group (5A, group 1 and group 2) and control group (5B). The horizontal axe is the mean value of eGFR_cr and eGFR_CysC results and the vertical axe is the difference value of eGFR_cr and eGFR_CysC. The solid blue lines represent the mean value of the difference. The top and bottom dotted lines are the 95% limits of agreement (95% LoA).

Table 2 Decreased Proportion of eGFRcr (or eGFR_Cysc) When Compared with Baseline Levels Among Four Groups

Decreased Proportion of eGFR	Group 1	Group 2	Group 3	Group 4	p-value^†	p-value^‡
>10% from baseline	30(81.1%)	19(82.6%)^a	20(42.5%)	19(61.3%)	<0.001	0.11
>20% from baseline	23(62.2%)	12(52.2%)^b	6(12.7%)	9(29.1%)	<0.001	0.07
>30% from baseline	16(43.2%)	3(13.1%)^c	0 (0.0%)	3(9.6%)	<0.001	0.03
<60(mL/min per 1.73 m2;)	3(8.1%)	1(4.3%)	0(0.0%)	1(3.2%)	0.15	0.40
<60 (mL/min per 1.73 m2; eGFRcysc)	5(13.5%)	5(21.8%)	3(6.3%)	1(3.2%)	0.17	0.92

Notes: P-value^†: ANOVA test between group 1 and group 2 and group 3; P-value^‡: comparison between group 3 vs group 4; a, b, c denotes comparison between group 1 and group 2: p=0.881, p=0.445, p=0.014 respectively.

Abbreviations: eGFRcr, estimating glomerular filtration rate based on creatinine; eGFR_Cysc, estimating glomerular filtration rate based on cystatin C.