Question

What can I used instead of Acriptega to protect my kidneys?

6 December 2023. Related: All topics, Changing treatment, Side effects.

Hello Simon and team, long time no asking a question.

I am now undetectable for almost 2 years. My CD4 went from 25 to 450 now and thanks god my health is very well now.

As previous checkup at my healthcare provider, the doctor said everything is ok except my eGFR is going down to 78 from 98. She said it is still in normal range but seems like the trend line is going down due to Acriptega which contains Tenofovir.

Can I ask you what is the best regimen to replace Acriptega to not damage kidney renal.

Answer

Answer: Josh Peasegood

Hi, how are you doing?

It is great to hear that your health is doing well and you are now undetectable. More so that your CD4 count has had such a good recovery over the last 2 years.

Has your doctor ruled out other causes of the decline in your eGFR? and have you been tested for makers of kidney damage e.g., protein/blood in the urine and albumin:creatinine ratio?

If you do not have any of these associated markers, your doctor is right and your kidneys are still in a healthy range even though the eGFR has gone down.

As you have mentioned Acrpitega contains tenofovir DF and this is known to cause problems with kidneys. It is safe to remain on this treatment with regular monitoring of kindey function to make sure it is not declining.

A suitable switch would be to go from tenofovir DF to tenofovir AF.

Tenofovir AF is more kidney protective. It is only available in certain formulations and will depend on what is available where you are. A common switch from a TLD formulation would be to move towards Biktarvy.

Josh.