Tenofovir and bone health

Grant, Philip; Cotter, Aoife G.

doi:10.1097/coh.0000000000000248

Cited by 116 publications

(96 citation statements)

References 52 publications

(50 reference statements)

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“…Similarly, in a small longitudinal study, TDF-treated HIV-infected Spanish adults with suboptimal vitamin D levels had greater PTH concentrations at week 24 (63.0 versus 54.3 pg/ml; P=0.05), and week 48 (67.5 versus 41.9 pg/ml; P=0.03) compared with those with normal vitamin D levels [12]. Hence, our findings underscore that both TDF use and vitamin D status have impact on PTH elevation, which is considered one of the underlying mechanisms of bone metabolism disturbance and bone mass deterioration in individuals with HIV [12,13,27]. The information regarding TDF's effects on bone turnover and bone mass in HIV-infected children and adolescents have been limited and conflicting [4,10].…”

Section: Discussionmentioning

confidence: 59%

Impact of Tenofovir Disoproxil Fumarate on Bone Metabolism and Bone Mass among Perinatally HIV-Infected Asian Adolescents

et al. 2016

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Section: Discussionmentioning

confidence: 59%

Impact of Tenofovir Disoproxil Fumarate on Bone Metabolism and Bone Mass among Perinatally HIV-Infected Asian Adolescents

et al. 2016

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“…One of the mechanisms of TDF‐associated bone loss has long been thought to be related to impaired renal tubular handling of phosphate . In this study, there was a comparable proportion of patients with baseline abnormal renal handing of phosphate as we previously reported .…”

Section: Discussionmentioning

confidence: 99%

Improvement of bone mineral density and markers of proximal renal tubular function in chronic hepatitis B patients switched from tenofovir disoproxil fumarate to tenofovir alafenamide

Fong

Lee

Tien

et al. 2019

Journal of Viral Hepatitis

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Tenofovir alafenamide (TAF) is a novel prodrug that reduces tenofovir plasma levels by 90% compared to tenofovir disoproxil fumarate (TDF), resulting in decreased bone mineral density (BMD) loss and renal toxicity. We aimed to study changes in BMD and markers of renal function of chronic hepatitis B (CHB) patients previously treated with TDF who were switched to TAF in as early as 12 weeks. This was a prospective single‐arm open‐label study of 75 CHB patients treated with TDF 300 mg daily who were switched to TAF 25 mg daily and followed for 24 weeks. All patients had been treated with TDF for at least 12 months and had HBV DNA <21 IU/mL at the time of switch. BMD and markers of renal function were taken on the day of switch and repeated after 12 and 24 weeks of TAF treatment. Hip and spine bone mineral density significantly increased from baseline to week 12 (+12.9% and +2.4%, respectively, P < 0.01). There were significant decreases in urinary beta‐2‐microglobulin to creatinine and retinol‐binding protein to creatinine ratios by week 12 (P < 0.01 for both). Mean estimated glomerular filtration rate (GFR) did not change. Tubular reabsorption of phosphate was decreased at week 24 (P < 0.05). In conclusion, CHB patients previously treated with TDF experienced significant improvement in bone density and some markers of renal tubular function and as early as 12 weeks after switching to TAF. Bone density changes associated with TDF may not be entirely related to renal handling of phosphate.

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“…In summary, this study suggests that, in urban, black South African women, HIV infection per se has no discernible effects on bone mineral status over a 12‐month period, but that exposure to TDF‐based ART is associated with loss of bone mineral and an increase in bone turnover. Newer prodrugs of TDF such as tenofovir alafenamide fumarate (TAF) have been demonstrated in controlled trials to be more bone‐sparing than TDF . TAF has been licensed in the United States and Europe but is not commonly available in Africa.…”

Section: Discussionmentioning

confidence: 99%

Changes in Bone Mineral Density, Body Composition, Vitamin D Status, and Mineral Metabolism in Urban HIV-Positive South African Women Over 12 Months

Hamill

Pettifor

Ward

et al. 2017

Journal of Bone and Mineral Research

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HIV infection and antiretroviral therapy (ART) are associated with bone loss and poor vitamin D status in Caucasian populations, though their relative roles are not known. No previous studies have examined longitudinal changes in areal bone mineral density (aBMD), measured by DXA, or in vitamin D status in HIV-positive African women. Of 247 premenopausal, urban, black African women from Soweto, South Africa, initially recruited, 187 underwent anthropometry, DXA scanning and blood and urine collections at both baseline and 12 months. Of these, 67 were HIVnegative throughout (Nref), 60 were HIV-positive with preserved CD 4 counts at baseline (Ppres) and 60 were HIV-positive with low CD 4 counts at baseline, eligible for ART by South African standards of care at the time (Plow). No participant had been exposed to ART at baseline. By 12 months, 51 Plow women had initiated ART, >85% of whom took combined tenofovir disoproxil fumarate (TDF), lamivudine and efavirenz. By 12 months, Plow and Nref, but not Ppres, increased in body weight and fat mass (group-by-timepoint p ≤0.001, p=0.002 respectively). Plow had significant decreases in aBMD of 2-3%, before and after size adjustment, at the femoral neck (p ≤0.002) and lumbar spine (p ≤0.001), despite significant weight gain. These decreases were associated with increased bone turnover but there were no significant differences or changes over time in vitamin D status, serum phosphate concentrations or renal phosphate handling. Excluding data from 9 Plow women unexposed to ART and 11 Ppres women who had initiated ART accentuated these findings, suggesting the bone loss in Plow was related to ART exposure. This is the first study describing DXA-defined bone loss in HIV-positive Sub-Saharan African women in Authors responsibilities: MMH, AP and JMP designed the study; MMH conducted the study; JMP and SAN provided senior oversight of the study in South Africa; KW provided senior oversight and interpretation of the DXA data; AP provided senior oversight and interpretation of the biochemical data; MMH and AP jointly conducted the statistical analysis and drafted the paper; all authors had full access to the data and contributed to interpretation of the findings. MMH and AP have responsibility for data integrity. All authors approved the manuscript for publication.The authors state that they have no conflicts of interest. Europe PMC Funders Group

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Tenofovir and bone health

Cited by 116 publications

References 52 publications

Impact of Tenofovir Disoproxil Fumarate on Bone Metabolism and Bone Mass among Perinatally HIV-Infected Asian Adolescents

Impact of Tenofovir Disoproxil Fumarate on Bone Metabolism and Bone Mass among Perinatally HIV-Infected Asian Adolescents

Improvement of bone mineral density and markers of proximal renal tubular function in chronic hepatitis B patients switched from tenofovir disoproxil fumarate to tenofovir alafenamide

Changes in Bone Mineral Density, Body Composition, Vitamin D Status, and Mineral Metabolism in Urban HIV-Positive South African Women Over 12 Months

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