Volume 7 Supplement 1

16th International Symposium on HIV and Emerging Infectious Diseases

Open Access

Tenofovir (TDF) containing first-line HAART is associated with changes in plasma parameters suggestive of increased bone resorption

  • Pablo Labarga1Email author,
  • Pablo Barreio1,
  • Carlos A Sanchez1,
  • Jose Medrano1,
  • Eugenia Vispo1,
  • Jose Vicente Fernandez1,
  • Francisco Blanco1,
  • Juan Gonzalez-Lahoz1 and
  • Vicente Soriano1
Retrovirology20107(Suppl 1):O13

DOI: 10.1186/1742-4690-7-S1-O13

Published: 11 May 2010

Background

Prolonged treatment with tenofovir (TDF) containing HAART is associated with reductions in kidney tubular resorption of phosphorus (P). Added to this, TDF may directly affect bone remodeling. Current study analyses the potential repercussion of Calcium (Ca) and P wasting on bone-mineral metabolism.

Methods

All consecutive asymptomatic HIV-infected patients starting first-line HAART were recruited. Patients receiving HARRT with vs without TDF were considered separately. Changes with respect to baseline values in Ca and P plasma levels, alkaline phosphatase (AP) concentration and parathyroid hormone (PTH) levels were analyzed in patients followed for longer than 12 months. Adherence >95% as assessed every 4 months was requested to remain in the study.

Results

A total of101 patients were included, 64 (63%) received TDF and 37 (37%) non-TDF containing HAART (mean age 38 years-old, 92% males, 90% Caucasians, mean CD4 count 278 cells/uL, mean HIV-RNA 4.3 log copies/mL, without differences between groups). After a mean follow up of 18 months, mean variation in bone-mineral metabolism plasma parameters with respect to baseline values, in patients under TDF vs non-TDF, was respectively as follows: P levels -0.31 mgr/dL [p < 0.001] vs -0.05 mg/dL [p = 0.7]; Ca levels +0.24 mg/dL [p = 0.005] vs +0.23 mg/dL [p = 0.36]; AP concentration +60 IU/L [p = 0.005] vs -36 IU/L [p = 0.09]; and PTH levels +20.3 pgr/mL [p = 0.02] vs +12.6 pgr/mL [p = 0.25].

Discussion

First-line HAART containing TDF, as compared with other nucleoside analogs, is associated with significant reductions in P levels, and increase in AP and PTH concentrations. These alterations are recognized markers of enhanced bone resorption, and may herald osteopenia in the long-term.

Authors’ Affiliations

(1)
Hospital Carlos III

Copyright

© Labarga et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd.

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