Renal mitochondrial toxicity: effects of thymidine analogues and tenofovir disoproxil fumarate in African people with HIV

Abstract

Summary We investigated the contributions of thymidine analogue (TA) and tenofovir disoproxil fumarate (TDF) anti-retroviral therapy on renal mitochondrial toxicity in Ghanaian PWH. Similar levels of renal biochemical and mitochondrial dysfunction were seen, and there was no increased risk in PWH who had sequenced from TA to TDF. However, mild renal impairment was associated with mitochondrial DNA damage in TDF but not TA-treated PWH. These data support the continued use of TDF in resource limited settings.

Tenofovir disoproxil and renal mitochondrial toxicity: more studies in Africans are needed

“…The common deletion was present in 32% of those not exposed to thymidine analogues (nucleoside RTI with systemic mitochondrial toxicity; mainly zidovudine) and in 37% of those exposed to TDF (P ¼ 0.22), and no more prevalent among those on TDF with prior exposure to thymidine analogues. In those exposed to TDF, the common deletion was associated with reduced eGFR but not with other markers of renal tubular dysfunction [6].…”

“…In the current issue of AIDS, Hunt et al [6] evaluated the presence of the mitochondrial DNA common deletion in urine samples from 97 west-African people with HIV (mean age 49 years, 74% women), including 38 on a TDF-containing regimen which they had been taking for a median of 81 months. The common deletion was present in 32% of those not exposed to thymidine analogues (nucleoside RTI with systemic mitochondrial toxicity; mainly zidovudine) and in 37% of those exposed to TDF (P ¼ 0.22), and no more prevalent among those on TDF with prior exposure to thymidine analogues.…”