Tenofovir disoproxil fumarate and bone mineral density: a 60-month longitudinal study in a cohort of HIV-infected youths.
BACKGROUND
Decreased bone mineral density (BMD) has been associated with the use of tenofovir disoproxil fumarate (TDF) in HIV-infected adults. The data in HIV-infected children are conflicting. The aim of this study was to assess the safety of a TDF-containing antiretroviral (ARV) regimen on BMD in paediatric patients. We report the results of a longitudinal 60-month follow-up study.


METHODS
A total of 21 vertically HIV-infected Caucasian youths (10 male and 11 female) on ARV treatment containing lamivudine, efavirenz and TDF were enrolled (age range 4.9-17.9 years at baseline). BMD was measured at the lumbar spine and in the whole skeleton by DXA. Bone-specific alkaline phosphatase (BAP) was measured as a bone formation marker and urinary N-telopeptide of type-I collagen (NTx) was measured as a bone resorption index.


RESULTS
Baseline mean (±sd) BMD measurements of HIV-infected patients expressed as z-scores were -0.7 (±0.9) for lumbar spine and -0.13 (±1.0) for the whole skeleton. BMD measurements did not change significantly during the 60-month observation period. Both BAP and NTx concentrations were higher than a reference group of controls at baseline and remained unchanged throughout the study.


CONCLUSIONS
Our data indicate that a TDF-containing regimen does not decrease the BMD of HIV-infected youths.
Pediatric Infectious Diseases Unit, Department of Pediatrics, L Sacco Hospital, University of Milan, Milan, Italy.
Alessandra
A
Viganò
Gian V
GV
Zuccotti
Maria
M
Puzzovio
Valentina
V
Pivetti
Ilaria
I
Zamproni
Chiara
C
Cerini
Valentina
V
Fabiano
Vania
V
Giacomet
Stefano
S
Mora
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015415:Biomarkers; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D024042:Collagen Type I / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D063065:Organophosphonates / Q000009:adverse effects* / Q000494:pharmacology; D010455:Peptides / Q000032:analysis; D000068698:Tenofovir; D055815:Young Adult
D015415:Biomarkers; D024042:Collagen Type I; D063065:Organophosphonates; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000068698:Tenofovir; D000225:Adenine