Intracellular tenofovir-diphosphate accumulation in an HIV-infected patient with Fanconi syndrome and osteomalacia
نویسندگان
چکیده
We present a patient with tenofovir disoproxil fumarate (TDF)-induced Fanconi syndrome, osteomalacia and concurrent nucleos(t)ide reverse transcriptase inhibitor related CD4 cell decline. Sequentially measured intracellular (ic) tenofovir-diphosphate (TFV-DP) levels were extremely high, with plasma TFV just slightly elevated. In June 2008 a 53-year-old Caucasian male complained of severe pain in his lower extremities. He was diagnosed with HIV in 1995 and developed some polyneuropathy and severe lipoatrophy after initiation of ART in 1996. In September 2003 TDF 300 mg qd, didanosine (ddI) 250 mg qd and lopinavir-ritonavir (LPV-r)
منابع مشابه
Bone scintigraphy and secondary osteomalacia due to nephrotoxicity in a chronic hepatitis B patient treated with tenofovir.
Tenofovir is a nucleotide analogue used for the treatment of chronic hepatitis B and HIV infection. The safety of tenofovir is high but it has been described that tenofovir produces tubular toxicity and Fanconi's syndrome in some HIV-infected patients. To our knowledge this is the first documented case of bone involvement in Fanconi's syndrome in a patient treated with tenofovir for chronic hep...
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We present an HIV-infected woman in whom antiretroviral treatment with tenofovir disoproxil fumarate (TDF) induced severe skeletal pain, synovial effusions and multiple fractures secondary to a Fanconi syndrome with hypophosphatemia and osteomalacia. TDF interferes with the replication of mitochondrial DNA in the proximal tubules of the kidney, which can explain the delayed onset of this form o...
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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 p...
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Tenofovir disoproxil fumarate (TDF) is one of the first-line treatment options in chronic hepatitis B (CHB). Despite its efficacy in suppressing viral load and a high resistance barrier, long life maintenance therapy is required. Registration studies demonstrated TDF to be a safe drug. However, post-marketing experience reported cases of serious nephrotoxicity associated with hypophosphatemia, ...
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