TITLE

Decline in Bone Mass With Tenofovir Disoproxil Fumarate/Emtricitabine Is Associated With Hormonal Changes in the Absence of Renal Impairment When Used by HIV-Uninfected Adolescent Boys and Young Men for HIV Preexposure Prophylaxis

AUTHOR(S)
Havens, Peter L.; Stephensen, Charles B.; Van Loan, Marta D.; Schuster, Gertrud U.; Woodhouse, Leslie R.; Flynn, Patricia M.; Gordon, Catherine M.; Pan, Cynthia G.; Rutledge, Brandy; Nancy Liu; Wilson, Craig M.; Hazra, Rohan; Hosek, Sybil G.; Anderson, Peter L.; Seifert, Sharon M.; Kapogiannis, Bill G.; Mulligan, Kathleen
PUB. DATE
February 2017
SOURCE
Clinical Infectious Diseases;2/1/2017, Vol. 64 Issue 3, p317
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background. We aimed to define the relative importance of renal and endocrine changes in tenofovir disoproxil fumarate (TDF)-related bone toxicity. Methods. In a study of daily TDF/emtricitabine (FTC) preexposure prophylaxis (PrEP) in human immunodeficiency virus (HIV)-uninfected young men who have sex with men, we measured changes from baseline in blood and urine markers of the parathyroid hormone (PTH)-vitamin D-fibroblast growth factor 23 (FGF23) axis, creatinine, and renal tubular reabsorption of phosphate (TRP). We explored the relationship of those variables to changes in bone mineral density (BMD). Tenofovir-diphosphate (TFV-DP) in red blood cells was used to categorize participants into high and low drug exposure groups. Results. There were 101 participants, median age 20 years (range 15 to 22). Compared with low drug exposure, high-exposure participants showed increase from baseline in PTH and decline in FGF23 by study week 4, with no differences in creatinine, phosphate, or TRP. At 48 weeks, the median (interquartile range) percent decline in total hip BMD was greater in those with high- compared to low- exposure (-1.59 [2.77] vs +1.54 [3.34] %, respectively; P = .001); in high-exposure participants, this correlated with week 4 TFV-DP (inversely; r = -0.60, P = .002) and FGF23 (directly; r = 0.42; P = .039) but not other variables. Conclusions. These findings support the short-term renal safety of TDF/FTC PrEP in HIV-seronegative young men and suggest that endocrine disruption (PTH-FGF23) is a primary contributor to TDF-associated BMD decline in this age group.
ACCESSION #
120787290

 

Related Articles

  • Single-Tablet Emtricitabine-Rilpivirine- Tenofovir as HIV Postexposure Prophylaxis in Men Who Have Sex With Men. Foster, Rosalind; McAllister, John; Read, Tim R.; Pierce, Anna B.; Richardson, Robyn; McNulty, Anna; Carr, Andrew // Clinical Infectious Diseases;10/15/2015, Vol. 61 Issue 8, p1336 

    Background: Completion rates for human immunodeficiency virus (HIV) postexposure prophylaxis (PEP) are low. We investigated the adherence and safety of coformulated emtricitabine (FTC), rilpivirine (RPV), and tenofovir disoproxil fumarate (TDF) as a 3-drug, single-tablet regimen for PEP in men...

  • No New HIV Infections With Increasing Use of HIV Preexposure Prophylaxis in a Clinical Practice Setting. Volk, Jonathan E.; Marcus, Julia L.; Phengrasamy, Tony; Blechinger, Derek; Nguyen, Dong Phuong; Follansbee, Stephen; Hare, C. Bradley // Clinical Infectious Diseases;11/15/2015, Vol. 61 Issue 10, p1601 

    Referrals for and initiation of preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection increased dramatically in a large clinical practice setting since 2012. Despite high rates of sexually transmitted infections among PrEP users and reported decreases in condom use in a...

  • No Evidence of Sexual Risk Compensation in the iPrEx Trial of Daily Oral HIV Preexposure Prophylaxis. Marcus, Julia L.; Glidden, David V.; Mayer, Kenneth H.; Liu, Albert Y.; Buchbinder, Susan P.; Amico, K. Rivet; McMahan, Vanessa; Kallas, Esper Georges; Montoya-Herrera, Orlando; Pilotto, Jose; Grant, Robert M. // PLoS ONE;Dec2013, Vol. 8 Issue 12, p1 

    Objective: Preexposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) reduced HIV acquisition in the iPrEx trial among men who have sex with men and transgender women. Self-reported sexual risk behavior decreased overall, but may be affected by reporting bias. We...

  • Scaling Up Antiretroviral Preexposure Prophylaxis: Moving From Trials to Implementation. Mayer, Kenneth H.; Krakower, Douglas S. // Clinical Infectious Diseases;11/15/2015, Vol. 61 Issue 10, p1598 

    The author discusses the study conducted by the authors related to Antiretroviral Preexposure Prophylaxis. Topics discussed include prevention of prevent human HIV transmission, sources of attenuation in the Atlanta HIV prevention, Antiretroviral Preexposure Prophylaxis (PrEP) risk for men who...

  • The Impact of Implementing a Test, Treat and Retain HIV Prevention Strategy in Atlanta among Black Men Who Have Sex with Men with a History of Incarceration: A Mathematical Model. Lima, Viviane D.; Graf, Isabell; Beckwith, Curt G.; Springer, Sandra; Altice, Frederick L.; Coombs, Daniel; Kim, Brian; Messina, Lauren; Montaner, Julio S. G.; Spaulding, Anne // PLoS ONE;Apr2015, Vol. 10 Issue 4, p1 

    Background: Annually, 10 million adults transition through prisons or jails in the United States (US) and the prevalence of HIV among entrants is three times higher than that for the country as a whole. We assessed the potential impact of increasing HIV Testing/Treatment/Retention (HIV-TTR) in...

  • LETTERS.  // Windy City Times;5/7/2014, Vol. 29 Issue 32, p14 

    A letter from the Center for HIV Educational Studies and Training (CHEST) to the AIDS Healthcare Foundation (AHF) president Michael Weinstein about the remarks on HIV Pre- Exposure Prophylaxis (PrEP) and the ability of Truvada in preventing HIV transmission is presented.

  • Antiretroviral Preexposure Prophylaxis for Heterosexual HIV Transmission in Botswana. Thigpen, Michael C.; Kebaabetswe, Poloko M.; Paxton, Lynn A.; Smith, Dawn K.; Rose, Charles E.; Segolodi, Tebogo M.; Henderson, Faith L.; Pathak, Sonal R.; Soud, Fatma A.; Chillag, Kata L.; Mutanhaurwa, Rodreck; Chirwa, Lovemore Ian; Kasonde, Michael; Abebe, Daniel; Buliva, Evans; Gvetadze, Roman J.; Johnson, Sandra; Sukalac, Thom; Thomas, Vasavi T.; Hart, Clyde // New England Journal of Medicine;8/2/2012, Vol. 367 Issue 5, p423 

    Background: Preexposure prophylaxis with antiretroviral agents has been shown to reduce the transmission of human immunodeficiency virus (HIV) among men who have sex with men; however, the efficacy among heterosexuals is uncertain. Methods: We randomly assigned HIV-seronegative men and women to...

  • HIV-1 Drug Resistance in the iPrEx Preexposure Prophylaxis Trial. Liegler, Teri; Abdel-Mohsen, Mohamed; Bentley, L. Gordon; Atchison, Robert; Schmidt, Timothy; Javier, Jacqueline; Mehrotra, Megha; Eden, Christopher; Glidden, David V.; McMahan, Vanessa; Anderson, Peter L.; Li, Peilin; Wong, Joseph K.; Buchbinder, Susan; Guanira, Juan V.; Grant, Robert M. // Journal of Infectious Diseases;Oct2014, Vol. 210 Issue 8, p1217 

    Background. The iPrEx study demonstrated that combination oral emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) as preexposure prophylaxis (PrEP) protects against HIV acquisition in men who have sex with men and transgender women. Selection for drug resistance could offset PrEP...

  • Four year follow-up of simplification therapy with once-daily emtricitabine, didanosine and efavirenz in HIV-infected patients (ALIZE ANRS 099 trial). Gallien, Sébastien; Journot, Valérie; Rozenbaum, Willy; Yéni, Patrick; Morlat, Philippe; Poizot-Martin, Isabelle; Reynes, Jacques; Reliquet, Véronique; Leclercq, Pascale; Simon, François; Chêne, Geneviève; Molina, Jean-Michel // Journal of Antimicrobial Chemotherapy (JAC);Jan2011, Vol. 66 Issue 1, p184 

    Background Once-daily combinations of efavirenz and two nucleoside analogues are recommended for the treatment of HIV infection. Long-term efficacy and safety data are scarce for the combination of efavirenz, emtricitabine and didanosine. Methods The ALIZE ANRS 099 trial enrolled 355 adults with...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics