Bone mineral density reductions after tenofovir disoproxil fumarate initiation and changes in phosphaturia: a secondary analysis of ACTG A5224s
| Autor: | Samir K. Gupta, Charles S. Venuto, Belinda Ha, Douglas Kitch, Todd T. Brown, Gene D. Morse, Grace A. McComsey, Kathleen Melbourne, Eunice Yeh |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male musculoskeletal diseases 0301 basic medicine Microbiology (medical) medicine.medical_specialty Efavirenz Bone density Anti-HIV Agents Urology Renal function HIV Infections Phosphates Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Bone Density immune system diseases Abacavir medicine Humans Pharmacology (medical) 030212 general & internal medicine Tenofovir skin and connective tissue diseases Hypophosphatemia Familial Original Research Pharmacology Bone mineral Hip business.industry virus diseases Middle Aged medicine.disease 030112 virology Virology Dideoxynucleosides Spine Atazanavir Infectious Diseases chemistry Female Ritonavir sense organs business Hypophosphatemia Glomerular Filtration Rate medicine.drug |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 72:2042-2048 |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/dkx076 |
| Popis: | Background It is unknown if the greater reductions in bone mineral density (BMD) associated with initiation of tenofovir disoproxil fumarate compared with abacavir in previously untreated HIV-infected participants in the ACTG A5224s clinical trial were associated with potentially worsening tenofovir-related phosphaturia. Methods We correlated changes in BMD at the hip and spine with changes in phosphaturia [transtubular reabsorption of phosphorus (TRP) and tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/GFR)] from entry through week 96 in those initiating tenofovir ( n = 134) versus abacavir ( n = 135) with efavirenz or atazanavir/ritonavir in A5224s. We also correlated changes in BMD with tenofovir AUC measured between weeks 4 and 24. Results Changes in TRP and TmP/GFR through week 96 between the tenofovir and abacavir arms were not significantly different (both P ≥ 0.70) and did not differ with use of efavirenz versus atazanavir/ritonavir. There were no significant correlations between changes in either TRP or TmP/GFR and with either hip or spine BMD in the tenofovir arms. Tenofovir AUC was significantly correlated with changes in hip BMD, but not spine BMD, at week 24 ( r = -0.22, P = 0.028) and week 48 ( r = -0.26, P = 0.010), but not at week 96 ( r = -0.14, P = 0.18). Conclusions Changes in phosphaturia were not different between the tenofovir and abacavir arms in A5224s. Changes in hip and spine BMD with tenofovir were not related to changes in phosphaturia. However, tenofovir exposure was weakly associated with changes in hip BMD through week 48. |
| Databáze: | OpenAIRE |
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