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Is tenofovir involved in hypophosphatemia and decrease of tubular phosphate reabsorption in HIV-positive adults?
Stéphanie Badiou1, Corinne Merle De Boever, Nathalie Terrier
1Department of Biochemistry, University Hospital, F34295 Montpellier, France.
The Journal of Infection
|September 24, 2005
Summary
Hypophosphatemia and impaired tubular phosphate reabsorption are common in HIV patients, independent of tenofovir use. This study found no worsening of these conditions after six months of tenofovir treatment.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Tubulopathy with hypophosphatemia is a known complication in HIV-positive patients on tenofovir.
- The exact incidence and prevalence of these issues, and their link to tubular reabsorption disorders, require further investigation.
Purpose of the Study:
- To investigate the effect of tenofovir on phosphatemia.
- To assess the impact of tenofovir on tubular phosphate reabsorption in HIV-positive patients.
Main Methods:
- A transversal study included 145 HIV-positive adults on tenofovir.
- A prospective study evaluated 29 HIV-positive adults before and at 3 and 6 months after tenofovir initiation.
- Phosphate, creatinine, glucose, and protein levels were measured in plasma and urine. Maximal tubular reabsorption capacity of phosphate (TmPO4)/glomerular filtration rate (GFR) was calculated.
Main Results:
- In the transversal study, 26% of patients had hypophosphatemia and 47% had decreased TmPO4/GFR.
- Baseline prevalence in the prospective study was 31% for hypophosphatemia and 41% for decreased TmPO4/GFR.
- No significant changes in phosphate levels or TmPO4/GFR were observed at 3 and 6 months post-tenofovir initiation, with stable prevalence of hypophosphatemia and decreased TmPO4/GFR.
Conclusions:
- Hypophosphatemia and reduced proximal tubular reabsorption are frequent in HIV-positive adults, irrespective of tenofovir.
- This preliminary study indicates that tenofovir does not worsen phosphatemia or tubular phosphate reabsorption within six months.
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