Longitudinal Evaluation of Liver and Renal Functions in Patients Undergoing Tenofovir Disoproxil Fumarate–Based Antiretroviral Therapy in Southern Vietnam

Introduction Tenofovir disoproxil fumarate (TDF)–based antiretroviral therapy (ART) is widely used to manage HIV due to its efficacy and affordability. However, its potential adverse effects on liver and renal functions remain significant concerns, particularly in resource‐limited settings such as Vietnam. Methods Prospective cohort study included 552 HIV‐infected patients with normal baseline liver and renal functions, who received TDF‐based ART at Thu Duc City Hospital. Clinical and laboratory data, including AST, ALT, and serum creatinine levels, were collected and analyzed over a 20‐month follow‐up period. Cox proportional hazards regression and Kaplan–Meier analyses were used to identify risk factors and time‐to‐onset of liver damage and renal impairment. Results The overall incidence of liver damage was 10.7%, while renal impairment was higher at 19.4%. Male sex and pretreatment AST levels emerged as independent predictors of renal impairment during TDF‐based ART. In multivariate Cox models, male sex showed a strong association with both liver damage (HR = 2.19, 95% CI: 1.10–4.34) and renal impairment (HR = 14.06, 95% CI: 5.39–36.65). Elevated baseline AST was independently associated with renal impairment (HR: 1.05, 95% CI 1.01–1.10, p = 0.029). Conclusion TDF‐based ART is associated with notable risks of liver and renal dysfunctions, particularly among male patients. Strengthened routine monitoring and individualized clinical management may help reduce these toxicities.