Daily PrEP is safe for the kidneys

[Jim Allen]

I would say that it's not an unexpected result but good they checked, and an interesting read for those interested.

Aidsmap.com in full:
https://www.aidsmap.com/news/dec-2022/daily-prep-safe-kidneys-although-demand-prep-has-slightly-less-impact

In short:

According to a recent study, oral PrEP has a very good renal safety profile even after two years of use. The study also shows that on-demand PrEP has less impact on kidney function than daily PrEP, although this difference is not clinically significant.

Of the 1,253 participants, 40% were daily PrEP users, 39% were on-demand PrEP users and 21% switched regimens. Participants were mostly (98%) men who have sex with men and European (85%), with a median age of 34.

The sample’s median eGFR at baseline was 104 (interquartile range 92 – 114). There were 43% of participants who had baseline risk factors for kidney dysfunction: age over 40 and/or a baseline eGFR below 90 mL/min/1.73 m2. 

As seen in previous studies, eGFR dropped in the first three months after starting PrEP but increased gradually until month 24, whatever the PrEP regimen.

It is worth noting that over a median of 22 months of follow-up, only five PrEP users, evenly distributed between the groups, experienced an eGFR reduction of over 25%. Only two participants stopped PrEP because of a decrease in eGFR and both restarted it later without problems.

Geoffroy Liegeon, Lambert Assoumou, Jade Ghosn, Mayssam El Mouhebb, Romain Palich, Christia Palacios, Laurence Slama, Laure Surgers, Michèle Genin, Lydie Beniguel, Lauriane Goldwirt, Claudine Duvivier, Daniela Rojas Castro, Dominique Costagliola, Jean-Michel Molina, on behalf of the ANRS-PREVENIR Study Group, Impact on renal function of daily and on-demand HIV pre-exposure prophylaxis in the ANRS-PREVENIR study, Journal of Antimicrobial Chemotherapy, Volume 77, Issue 12, December 2022, Pages 3427–3435, https://doi.org/10.1093/jac/dkac336