title: Tenofovir-induced Fanconi syndrome in a patient with chronic hepatitis B monoinfection.
abstract: Tenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor indicated for treatment of patients with chronic hepatitis B virus (CHB) and human immunodeficiency virus (HIV) infections. Despite the good safety profile of the drug, Fanconi syndrome is a possible adverse reaction of TDF treatment, especially in HIV-infected patients. Only a few cases have been reported in patients with CHB-monoinfections. This report presents a case of a 58-year-old man with mild HBeAg-negative CHB who was exposed to TDF and developed drug-induced Fanconi syndrome. Renal dysfunction reverted after TDF discontinuation and a switch to entecavir, and viral replication remained suppressed. A literature review yielded six additional cases of TDF-induced Fanconi syndrome, all with risk factors for renal dysfunction despite the patients having normal glomerular filtration rates. We discuss the overall risk for Fanconi syndrome in CHB-monoinfected patients exposed to TDF and the importance of careful monitoring of glomerular and tubular functions even when pre-existing kidney disease is not present.
authors: Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
authors: Fabio
authors: F
authors: Conti
authors: Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
authors: Giovanni
authors: G
authors: Vitale
authors: Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
authors: Carmela
authors: C
authors: Cursaro
authors: Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
authors: Mauro
authors: M
authors: Bernardi
authors: Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
authors: Pietro
authors: P
authors: Andreone
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects*; D000069340:Deprescriptions; D005198:Fanconi Syndrome / Q000139:chemically induced*; D005919:Glomerular Filtration Rate; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D000068698:Tenofovir / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir