OBJECTIVES: Tenofovir disoproxil fumarate (TDF) may cause renal tubular dysfunction (RTD) and reduce bone mineral density (BMD). We examined the relationship between RTD and BMD in TDF-exposed HIV-positive men. DESIGN AND METHODS: We analysed urinary retinol-binding protein/creatinine ratio (RBPCR) and fractional excretion of phosphate (FEPO4) to quantify RTD in a cross-sectional sample of randomly selected HIV-positive men at a single tertiary outpatient clinic. BMD at the lumbar spine and hip was measured by dual-energy X-ray absorptiometry. Multivariate logistic regression was used to analyse factors associated with RTD, and linear regression to examine the relationship between RTD and BMD. RESULTS: Of 293 men (mean age 48 years, 94% White ethnicity, median TDF exposure 2.1 years), 22.5% had RBPCR-defined RTD and 12.3% had FEPO4-defined RTD. We observed a negative correlation between RBPCR and BMD at the spine (β -0.2, P = 0.002) and hip (total: β -0.1, P = 0.02; femoral neck: β -0.1, P = 0.02), but not between FePO4 and BMD. In multivariable analyses, RTD defined by more than five-fold elevations in RBPCR was associated with significantly lower BMD of the spine. CONCLUSION: In HIV-positive patients receiving TDF-containing antiretroviral therapy, RTD was associated with lower BMD of the spine in HIV-positive men. RBPCR quantification may identify patients at increased risk of TDF-associated BMD loss.
OBJECTIVES: Tenofovir disoproxil fumarate (TDF) may cause renal tubular dysfunction (RTD) and reduce bone mineral density (BMD). We examined the relationship between RTD and BMD in TDF-exposed HIV-positive men. DESIGN AND METHODS: We analysed urinary retinol-binding protein/creatinine ratio (RBPCR) and fractional excretion of phosphate (FEPO4) to quantify RTD in a cross-sectional sample of randomly selected HIV-positive men at a single tertiary outpatient clinic. BMD at the lumbar spine and hip was measured by dual-energy X-ray absorptiometry. Multivariate logistic regression was used to analyse factors associated with RTD, and linear regression to examine the relationship between RTD and BMD. RESULTS: Of 293 men (mean age 48 years, 94% White ethnicity, median TDF exposure 2.1 years), 22.5% had RBPCR-defined RTD and 12.3% had FEPO4-defined RTD. We observed a negative correlation between RBPCR and BMD at the spine (β -0.2, P = 0.002) and hip (total: β -0.1, P = 0.02; femoral neck: β -0.1, P = 0.02), but not between FePO4 and BMD. In multivariable analyses, RTD defined by more than five-fold elevations in RBPCR was associated with significantly lower BMD of the spine. CONCLUSION: In HIV-positive patients receiving TDF-containing antiretroviral therapy, RTD was associated with lower BMD of the spine in HIV-positive men. RBPCR quantification may identify patients at increased risk of TDF-associated BMD loss.
Authors: Marco Borderi; Davide Gibellini; Fabio Vescini; Elisa De Crignis; Laura Cimatti; Carlo Biagetti; Livia Tampellini; Maria C Re Journal: AIDS Date: 2009-07-17 Impact factor: 4.177
Authors: Mar Masiá; Sergio Padilla; Catalina Robledano; Natividad López; José Manuel Ramos; Felix Gutiérrez Journal: AIDS Res Hum Retroviruses Date: 2011-07-19 Impact factor: 2.205
Authors: Jean C Yombi; Anton Pozniak; Marta Boffito; Rachael Jones; Saye Khoo; Jeremy Levy; Frank A Post Journal: AIDS Date: 2014-03-13 Impact factor: 4.177
Authors: Clare L N Woodward; A M Hall; I G Williams; S Madge; A Copas; D Nair; S G Edwards; M A Johnson; J O Connolly Journal: HIV Med Date: 2009-05-06 Impact factor: 3.180
Authors: Allison Martin; Mark Bloch; Janaki Amin; David Baker; David A Cooper; Sean Emery; Andrew Carr Journal: Clin Infect Dis Date: 2009-11-15 Impact factor: 9.079
Authors: Samir K Gupta; Albert M Anderson; Ramin Ebrahimi; Todd Fralich; Hiba Graham; Valeska Scharen-Guivel; John F Flaherty; Claude Fortin; Robert C Kalayjian; Anita Rachlis; Christina M Wyatt Journal: PLoS One Date: 2014-03-20 Impact factor: 3.240
Authors: Ian Williams; Duncan Churchill; Jane Anderson; Marta Boffito; Mark Bower; Gus Cairns; Kate Cwynarski; Simon Edwards; Sarah Fidler; Martin Fisher; Andrew Freedman; Anna Maria Geretti; Yvonne Gilleece; Rob Horne; Margaret Johnson; Saye Khoo; Clifford Leen; Neal Marshall; Mark Nelson; Chloe Orkin; Nicholas Paton; Andrew Phillips; Frank Post; Anton Pozniak; Caroline Sabin; Roy Trevelion; Andrew Ustianowski; John Walsh; Laura Waters; Edmund Wilkins; Alan Winston; Mike Youle Journal: HIV Med Date: 2012-09 Impact factor: 3.180
Authors: Julie J Kim-Chang; Lorena Wilson; Cliburn Chan; Bernard Fischer; Guglielmo Venturi; Maureen M Goodenow; Grace Aldrovandi; Thomas J Weber; John W Sleasman Journal: AIDS Res Hum Retroviruses Date: 2019-06-27 Impact factor: 2.205
Authors: Robert C Kalayjian; Jeffrey M Albert; Serge Cremers; Samir K Gupta; Grace A McComsey; Karin L Klingman; Carl J Fichtenbaum; Todd T Brown; Babafemi O Taiwo Journal: AIDS Date: 2018-11-13 Impact factor: 4.177
Authors: Evelyn Hsieh; Liana Fraenkel; Yang Han; Weibo Xia; Karl L Insogna; Michael T Yin; Ting Zhu; Xinqi Cheng; Taisheng Li Journal: AIDS Date: 2016-07-31 Impact factor: 4.177
Authors: Cecilia Costa; Silvia Scabini; Arvind Kaimal; William Kasozi; Jessica Cusato; Bosco Kafufu; Marco Borderi; Erisa Mwaka; Giovanni Di Perri; Mohammed Lamorde; Andrea Calcagno; Barbara Castelnuovo Journal: J Infect Dis Date: 2020-06-29 Impact factor: 5.226
Authors: Samir K Gupta; Eunice Yeh; Douglas W Kitch; Todd T Brown; Charles S Venuto; Gene D Morse; Belinda Ha; Kathleen Melbourne; Grace A McComsey Journal: J Antimicrob Chemother Date: 2017-07-01 Impact factor: 5.758