Document Detail

Is tenofovir involved in hypophosphatemia and decrease of tubular phosphate reabsorption in HIV-positive adults?
MedLine Citation:
PMID:  16176835     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Tubulopathy with hypophosphatemia have been observed in HIV-positive patients receiving a tenofovir-containing regimen. However, the real incidence and prevalence of hypophosphatemia and their relation to tubular reabsorption disorders in tenofovir-treated patients remain uncertain. The aim of our study was to explore the effect of tenofovir on phosphatemia and on tubular phosphate reabsorption. METHODS: In a first transversal study, 145 HIV-positive adults (44+/-9 years) receiving tenofovir 300 mg daily with a mean exposure of 11+/-9 months were included. In a second prospective study, 29 HIV-positive antiretroviral experienced adults (44+/-10 years) were evaluated before introduction of tenofovir 300 mg daily (M0) and at 3 months (M3) and 6 months (M6), thereafter. Phosphate, creatinine, glucose and protein levels were determined in plasma and urine. The ratio of maximal reabsorption capacity (TmPO4)/glomerular filtration rate (GFR) was determined by using the normogramm of Walton and Bijvoet. RESULTS: In the transversal study, 26% of patients had hypophosphatemia (<0.84 mmol/l) while 47% of patients had a decreased TmPO4/GFR (<0.8 mmol/l). In the prospective study, baseline prevalence of hypophosphatemia (<0.84 mmol/l) and decreased TmPO4/GFR (<0.8mmol/l) was 31 and 41%, respectively. Three and 6 months after starting tenofovir, there is no significant change in mean phosphate levels (M0:0.91 mmol/l, M3:0.97 mmol/l, M6:0.98 mmol/l) and mean TmPO4/GFR (M0:0.80 mmol/l, M3:0.88 mmol/l, M6:0.84 mmol/l). Moreover, prevalence of hypophosphatemia (M3:28%, M6:28%) and decreased TmPO4/GFR (M3:41%, M6:45%) remained stable. CONCLUSION: Hypophosphatemia linked to a decreased proximal tubular reabsorption was frequently observed in HIV-positive adults independently of the use of tenofovir. In this preliminary study, no worsening effect on phosphatemia and tubular phosphate reabsorption was observed 6 months after introduction of tenofovir in treatment experienced patients.
Stéphanie Badiou; Corinne Merle De Boever; Nathalie Terrier; Vincent Baillat; Jean-Paul Cristol; Jacques Reynes
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2005-09-19
Journal Detail:
Title:  The Journal of infection     Volume:  52     ISSN:  1532-2742     ISO Abbreviation:  J. Infect.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-25     Completed Date:  2006-10-24     Revised Date:  2007-12-14    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  335-8     Citation Subset:  IM    
Department of Biochemistry, University Hospital, F34295 Montpellier, France.
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MeSH Terms
Adenine / adverse effects,  analogs & derivatives*,  therapeutic use
Anti-HIV Agents / adverse effects*,  therapeutic use
Cross-Sectional Studies
HIV Infections / drug therapy*
Hypophosphatemia / chemically induced*
Kidney Tubules, Proximal / drug effects*,  metabolism
Middle Aged
Phosphates / metabolism
Phosphonic Acids / adverse effects*,  therapeutic use
Reg. No./Substance:
0/Anti-HIV Agents; 0/Phosphates; 0/Phosphonic Acids; 107021-12-5/tenofovir; 73-24-5/Adenine

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