Determinants of bone diseases in tenofovir-treated HIV patients

Gervasoni, Cristina; Minisci, Davide; Meraviglia, Paola; Baldelli, Sara; Clementi, Emilio; Rizzardini, Giuliano; Cattaneo, Dario

doi:10.1097/qad.0000000000001094

Cited by 1 publication

(2 citation statements)

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“…Our finding agrees in part with Gervasoni et al 23 who did not find the association between plasma TFV concentration and CTx. Similarly, in a study performed by Havens et al 15 of mostly African American race (n = 118), no correlation was found between plasma TFV concentration and SrCa, PTH, SrP, BALP and CTx.…”

Section: Variable (Mean and Sd)supporting

confidence: 93%

“…The mean PTH was, however, significantly higher at ≥ 120 ng/mL plasma TFV which suggested the possibility of stimulated bone resorption, as higher plasma PTH concentrations are associated with low BMD. 22 This could also be as a result of TFV-induced cellular stress that affects osteoblast function leading to decreased bone formation as proposed by Grigsby et al 13 In the study by Gervasoni et al (n = 133), 23 higher TFV plasma concentrations (288 ng/mL ± 173 ng/mL) were found in patients with altered osteocalcin (bone formation marker) concentrations than in patients with normal osteocalcin concentrations (153 ng/mL ± 115 ng/mL, p < 0.01).…”

Section: Variable (Mean and Sd)mentioning

confidence: 93%

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Bone turnover markers in HIV-infected women on tenofovir-based antiretroviral therapy

Mulubwa

Viljoen

Kruger

et al. 2017

South. Afr. j. HIV med.

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How to cite this article:Mulubwa M, Viljoen M, Kruger IM, Kruger HS, Rheeders M. Bone turnover markers in HIV-infected women on tenofovir-based antiretroviral therapy. S Afr J HIV Med. 2017;18(1), a739. https://doi.org/10.4102/ sajhivmed.v18i1.739 IntroductionLow bone mineral density (BMD) is common among persons infected with human immunodeficiency virus (HIV).1 In HIV-infected people, causes of osteoporosis, fractures and low BMD are multifactorial, involving traditional risk factors (smoking, alcohol use, low body weight and physical inactivity), but also genetics and HIV-infection per se.1,2 Exposure to antiretroviral treatment (ART), especially nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs) in HIV-infected people, is associated with low BMD.3 Osteomalacia was reported in patients on a tenofovir disoproxil fumarate (TDF)-based ART regimen that was characteristic of hypophosphataemia and increased serum alkaline phosphatase (ALP). 4In clinical studies, TDF-based ART regimens were reported to be associated with decreased BMD, characterised by increased serum concentrations of bone turnover markers (BTMs). These include bone resorption markers such as C-terminal telopeptide (CTx) and bone formation markers such as procollagen type 1 N-terminal propeptide (P1NP), bone-specific ALP (BALP) osteocalcin and ALP. 5,6,7,8 Furthermore, increased bone turnover, after initiation of TDF therapy, was characterised by elevated serum concentrations of parathyroid hormone (PTH).9 However, elevated serum concentrations of PTH were more profound in patients with vitamin D (VitD) deficiency. 10,11,12 Tenofovir disoproxil fumarate undergoes initial di-ester hydrolysis in plasma to tenofovir (TFV). A proposed bone loss mechanism associated with TFV, a phosphonate, is selective uptake by osteoclasts via a mechanism similar to that of bisphosphonates, which eventually cause cellular stress. 13 Resulting cellular stress perturbs deoxyribonucleic (DNA) synthesis by altering gene expression that is involved in signalling osteoblast activity resulting in decreased bone formation.13,14 Despite studies 3,5,7 performed on the relationship between TDF-use and bone Background: Tenofovir disoproxil fumarate (TDF) antiretroviral therapy is associated with disruption of the bone turnover process. Objectives:The objective of this study was to determine the association between tenofovir (TFV) plasma concentration and various bone turnover markers and compare these markers in HIV-infected women and HIV-uninfected controls. Method:A cross-sectional sub-study included 30 HIV-infected women on TDF and 30 HIVuninfected matched participants. Serum calcium (SrCa), serum phosphate (SrP), C-terminal telopeptide (CTx), parathyroid hormone (PTH), alkaline phosphatase (ALP), C-reactive protein (CRP), vitamin D (VitD) and bone mineral density (BMD) were measured. Plasma TFV was assayed on HPLC-MS/MS. The statistical tests applied were Mann-Whitney test, unpaired t-test, analysis of covariance, regression and correlation anal...

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Section: Variable (Mean and Sd)supporting

confidence: 93%