HIV Infection, Use of Tenofovir and Other Antiretrovirals, and Risk of Fatal and Non-Fatal Comorbidities: Cohort Study in Kaiser Permanente

Although the benefits of combination antiretroviral therapy (ART) for reducing HIV-related morbidity and mortality are well-recognized, toxicity from some ART may potentially contribute to excess age-related comorbidities. Certain antiretrovirals, including tenofovir, have known renal toxicity, but recent formulations may be associated with improved outcomes. Tenofovir-based ART is also increasingly used in high-risk HIV-uninfected individuals for HIV preexposure prophylaxis (PrEP), although the long-term health outcomes are unknown. The goal of this study is to characterize the incidence and predictors of key fatal and non-fatal comorbidities in HIV patients, and in demographically similar comparison groups of HIV-uninfected patients, including a general population sample, and HIV-uninfected individuals prescribed PrEP. This research will be conducted in approximately 39,000 HIV-infected and 390,000 HIV-uninfected subjects from Kaiser Permanente Northern California, Kaiser Permanente Southern California, and Kaiser Permanente of the Mid-Atlantic States.

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