Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5666790 | International Journal of Antimicrobial Agents | 2017 | 6 Pages |
â¢Tenofovir disoproxil fumarate (TDF) has been associated with skeletal side effects in adults.â¢We show that bone mineral density does not decrease in HIVâinfected children on TDF.â¢Longâterm use of TDF in young patients is not detrimental to bone health.
BackgroundThe use of tenofovir disoproxil fumarate (TDF) has simplified the antiretroviral regimen for HIVâinfected patients and improved their compliance with treatment, but it has been associated with decreased bone mineral density (BMD) in adult patients, and data in pediatric patients are debated. The aim of the current study was to assess the longâterm effect of TDF on BMD in young patients.MethodsBMD was measured at the lumbar spine and in the whole skeleton in 26 HIV-infected youths (13 female and 13 male, aged 5 to 17 years at baseline). BMD was measured yearly for 10 years as part of standard care. BMD changes were compared with those calculated from 202 healthy subjects aged 3 to 24 years.FindingsAll patients had good control of the infection during the 10-year study. BMD measurements changed significantly (Pâ<0ââ â0001) in HIVâinfected youths. The mean annual BMD increment at the lumbar spine was 0ââ â046 (0ââ â006) g/cm2 and 0ââ â042 (0ââ â006) g/cm2 in males and females, respectively. The differences between the slopes of patients and healthy controls were not significant. The annual BMD increment of the whole skeleton was 0ââ â030 (0ââ â005) g/cm2 in males and 0ââ â019 (0ââ â004) g/cm2 in females. The slopes of BMD changes of patients and healthy controls did not differ significantly.InterpretationThese data indicate that treatment with a TDFâcontaining antiretroviral regimen does not impair BMD in young patients with HIVâinfection. Larger studies are needed to confirm these results.