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Bone mineral density reductions after tenofovir disoproxil fumarate initiation and changes in phosphaturia: a secondary analysis of ACTG A5224s
- Source :
- Journal of Antimicrobial Chemotherapy. 72:2042-2048
- Publication Year :
- 2017
- Publisher :
- Oxford University Press (OUP), 2017.
-
Abstract
- Background It is unknown if the greater reductions in bone mineral density (BMD) associated with initiation of tenofovir disoproxil fumarate compared with abacavir in previously untreated HIV-infected participants in the ACTG A5224s clinical trial were associated with potentially worsening tenofovir-related phosphaturia. Methods We correlated changes in BMD at the hip and spine with changes in phosphaturia [transtubular reabsorption of phosphorus (TRP) and tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/GFR)] from entry through week 96 in those initiating tenofovir ( n = 134) versus abacavir ( n = 135) with efavirenz or atazanavir/ritonavir in A5224s. We also correlated changes in BMD with tenofovir AUC measured between weeks 4 and 24. Results Changes in TRP and TmP/GFR through week 96 between the tenofovir and abacavir arms were not significantly different (both P ≥ 0.70) and did not differ with use of efavirenz versus atazanavir/ritonavir. There were no significant correlations between changes in either TRP or TmP/GFR and with either hip or spine BMD in the tenofovir arms. Tenofovir AUC was significantly correlated with changes in hip BMD, but not spine BMD, at week 24 ( r = -0.22, P = 0.028) and week 48 ( r = -0.26, P = 0.010), but not at week 96 ( r = -0.14, P = 0.18). Conclusions Changes in phosphaturia were not different between the tenofovir and abacavir arms in A5224s. Changes in hip and spine BMD with tenofovir were not related to changes in phosphaturia. However, tenofovir exposure was weakly associated with changes in hip BMD through week 48.
- Subjects :
- Adult
Male
musculoskeletal diseases
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Efavirenz
Bone density
Anti-HIV Agents
Urology
Renal function
HIV Infections
Phosphates
Young Adult
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Bone Density
immune system diseases
Abacavir
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Tenofovir
skin and connective tissue diseases
Hypophosphatemia, Familial
Original Research
Pharmacology
Bone mineral
Hip
business.industry
virus diseases
Middle Aged
medicine.disease
030112 virology
Virology
Dideoxynucleosides
Spine
Atazanavir
Infectious Diseases
chemistry
Female
Ritonavir
sense organs
business
Hypophosphatemia
Glomerular Filtration Rate
medicine.drug
Subjects
Details
- ISSN :
- 14602091 and 03057453
- Volume :
- 72
- Database :
- OpenAIRE
- Journal :
- Journal of Antimicrobial Chemotherapy
- Accession number :
- edsair.doi.dedup.....d821a3f8d11cefa8d14757bb755c2aef