Bone outcomes in virally suppressed youth with HIV switching to tenofovir disoproxil fumarate
| Autor: | Michael T. Yin, Karl-Günter Technau, Stephen M. Arpadi, Kate Braithwaite, Tristan D McPherson, Gillian Sorour, Yanhan Shen, Stephanie Shiau |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
south africa
medicine.medical_specialty Efavirenz Tenofovir Human immunodeficiency virus (HIV) Renal function medicine.disease_cause bone chemistry.chemical_compound Abacavir Internal medicine Medicine adolescents Original Research Bone mineral renal tenofovir disoproxil fumarate South Africa business.industry Regimen Infectious Diseases chemistry Lumbar spine Public aspects of medicine RA1-1270 business medicine.drug |
| Zdroj: | Southern African Journal of HIV Medicine; Vol. 22 No. 1 (2021) Southern African Journal of HIV Medicine, Vol 22, Iss 1, Pp e1-e8 (2021) Southern African Journal of HIV Medicine |
| ISSN: | 1608-9693 2078-6751 |
| Popis: | Background:Tenofovir disoproxil fumarate (TDF) is included in first-line antiretroviral treatment (ART) for adolescents living with HIV (ALWH). Associated toxicities remain a concern. Objective:We evaluated bone and renal safety outcomes in virologically suppressed South African ALWH after switching to TDF. Method:We recruited virally suppressed (< 100 copies/mL) adolescents, aged 15–20 years, who switched from an abacavir (ABC)-based to a TDF-based efavirenz regimen. Bone mass and renal function were assessed at Week 0 and at Week 24 after the switch to TDF using dual-energy X-ray absorptiometry (DXA) and serum renal markers. A change in the lumbar spine (LS) and the whole-body less head (WBLH) bone mineral density (BMD) Z-scores and the estimated glomerular filtration rate (eGFR) between the two measures were compared (pairedt-tests) and stratified by sex. Results:Fifty participants (48% male), with a median duration of prior ART of 11.4 years, were enrolled. Among 47 participants with 24-week DXA results, 15 (32%) had either no change or a decreased LS-BMD after the switch, with a mean change of –1.6%. Overall, more female participants experienced this outcome: 58% versus 4%,P< 0.0001. The mean change (standard deviation) in the LS-Z-score was –0.03 (0.25) and in the WBLH-Z-score was 0.02 (0.24). A decrease in the eGFR from 132.2 to 120.4 was observed (P= 0.0003); however, the levels remained clinically acceptable. Conclusion:South African ALWH switching from abacavir to TDF-based ART experienced statistically significant decreases in eGFR but not in LS and WBLH BMD. Female ALWH were more likely to experience a decrease in LS-BMD and may require closer monitoring. |
| Databáze: | OpenAIRE |
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