Document Detail


The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity.
MedLine Citation:
PMID:  22984574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tenofovir has been associated with renal phosphate wasting, reduced bone mineral density, and higher parathyroid hormone levels. The aim of this study was to carry out a detailed comparison of the effects of tenofovir versus non-tenofovir use on calcium, phosphate and, vitamin D, parathyroid hormone (PTH), and bone mineral density.
METHODS: A cohort study of 56 HIV-1 infected adults at a single centre in the UK on stable antiretroviral regimes comparing biochemical and bone mineral density parameters between patients receiving either tenofovir or another nucleoside reverse transcriptase inhibitor.
PRINCIPAL FINDINGS: In the unadjusted analysis, there was no significant difference between the two groups in PTH levels (tenofovir mean 5.9 pmol/L, 95% confidence intervals 5.0 to 6.8, versus non-tenofovir; 5.9, 4.9 to 6.9; p = 0.98). Patients on tenofovir had significantly reduced urinary calcium excretion (median 3.01 mmol/24 hours) compared to non-tenofovir users (4.56; p<0.0001). Stratification of the analysis by age and ethnicity revealed that non-white men but not women, on tenofovir had higher PTH levels than non-white men not on tenofovir (mean difference 3.1 pmol/L, 95% CI 5.3 to 0.9; p = 0.007). Those patients with optimal 25-hydroxyvitamin D (>75 nmol/L) on tenofovir had higher 1,25-dihydroxyvitamin D [1,25(OH)(2)D] (median 48 pg/mL versus 31; p = 0.012), fractional excretion of phosphate (median 26.1%, versus 14.6; p = 0.025) and lower serum phosphate (median 0.79 mmol/L versus 1.02; p = 0.040) than those not taking tenofovir.
CONCLUSIONS: The effects of tenofovir on PTH levels were modified by sex and ethnicity in this cohort. Vitamin D status also modified the effects of tenofovir on serum concentrations of 1,25(OH)(2)D and phosphate.
Authors:
Karen Klassen; Adrian R Martineau; Robert J Wilkinson; Graham Cooke; Alan P Courtney; Mary Hickson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-12
Journal Detail:
Title:  PloS one     Volume:  7     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2012  
Date Detail:
Created Date:  2012-09-17     Completed Date:  2013-03-12     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e44845     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adenine / analogs & derivatives*,  pharmacology
Adult
Anti-HIV Agents / pharmacology*
Bone Density
Calcium / metabolism
Cohort Studies
Ethnic Groups
Female
HIV Infections / drug therapy*,  ethnology
Humans
Male
Middle Aged
Organophosphonates / pharmacology*
Parathyroid Hormone / metabolism
Phosphates / metabolism
Prospective Studies
Regression Analysis
Sex Factors
Vitamin D / metabolism*
Grant Support
ID/Acronym/Agency:
088316//Wellcome Trust; MC_U117588499//Medical Research Council; U.1175.02.002.00014.01//Medical Research Council
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Organophosphonates; 0/Parathyroid Hormone; 0/Phosphates; 107021-12-5/tenofovir; 1406-16-2/Vitamin D; JAC85A2161/Adenine; SY7Q814VUP/Calcium
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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