Renal and Bone Adverse Effects of a Tenofovir-Based Regimen in the Treatment of HIV-Infected Children: A Systematic Review

Safety and efficacy of abacavir for treating infants, children, and adolescents living with HIV: a systematic review and meta-analysis

“…1 Abacavir is a nucleoside reverse transcriptase inhibitor that has progressively replaced stavudine (d4T) due to fewer toxic effects, such as lipodystrophy and metabolic abnormalities. 2,3 Abacavir is also preferred to tenofovir disoproxil fumarate for infants and children due to concerns about renal toxic effects and loss of bone mineral density in this population, 4 and the absence of a paediatric formulation of tenofovir disoproxil fumarate. 5 Thus, in the WHO consolidated guidelines on HIV prevention, 6 abacavir is part of the preferred firstline regimen for children aged 4 weeks or older weighing at least 3 kg, coupled with lamivudine and dolutegravir or alternatively ritonavirboosted lopinavir; whereas, tenofovir disoproxil fumarate is preferred to abacavir as a firstline regimen for individuals aged 10 years or older or those weighing at least 35 kg.…”

It is Time to Explore the Potential Benefit of Routine Micronutrient Supplementation in Optimizing Bone Health and Growth in HIV Exposed Uninfected Children in the Context of Early Antiretroviral Exposure in Resource Limited Settings

“…5 Some of the major risk factors of decreased BMD in HIV infected children include antiretroviral therapy (ART) related toxic effects particularly with tenofovir disoproxil fumarate (TDF) containing regimens. 2,8 There is some evidence that micronutrient supplementation in HIV infected children improves growth and BMD. In a longitudinal study involving 37 perinatally HIV infected children done in USA, multivitamin use was independently associated with higher BMD Z-scores among multivitamin users compared to non-users.…”