Tenofovir-associated nephrotoxicity in two HIV-infected adolescent males.
We report two cases of tenofovir (TDF)-associated nephrotoxicity in perinatally HIV-infected adolescents. The first case, a 16-year-old African American male with an absolute CD4+ cell count of 314 cells/mm(3), presented with an abrupt rise in serum creatinine leading to irreversible renal failure while on TDF-containing highly active antiretroviral therapy (HAART). While the patient had evidence of underlying kidney disease, the timing of his renal failure indicates that TDF played a central role. The second case, a 16-year-old African-American male with an absolute CD4+ cell count of 895 cells/mm3, presented with rickets and hypophosphatemia while receiving TDF-based HAART. To our knowledge, these cases represent the first reports of TDF-associated irreversible renal failure and rickets in pediatric patients. We believe these cases highlight important and potentially irreversible side effects of this agent and emphasize the need for further studies of the renal safety of TDF in pediatric patients.
Wood
Sarah M
SM
Division of Special Immunology, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania 19104, USA.
Shah
Samir S
SS
Steenhoff
Andrew P
AP
Meyers
Kevin E C
KE
Kaplan
Bernard S
BS
Rutstein
Richard M
RM
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives*; D000293:Adolescent; D001741:Black or African American / Q000208:ethnology; D000367:Age Factors; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D001806:Blood Urea Nitrogen; D018791:CD4 Lymphocyte Count; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000635:transmission; D006801:Humans; D017674:Hypophosphatemia / Q000139:chemically induced; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D063065:Organophosphonates / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D012279:Rickets / Q000139:chemically induced; D012307:Risk Factors; D012449:Safety; D000068698:Tenofovir
D019380:Anti-HIV Agents; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D003404:Creatinine; D000225:Adenine