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Review of tenofovir use in HIV-infected children

Linda Aurpibul1, Thanyawee Puthanakit

  • 1From the *Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand; †Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; and ‡HIVNAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand.

The Pediatric Infectious Disease Journal
|September 24, 2014
PubMed

Insights

Tenofovir disoproxil fumarate (TDF) is a preferred HIV medication for children and adults. While effective and convenient, ongoing monitoring for renal and bone health is crucial in pediatric patients.

Area of Science:

  • Pediatric infectious diseases
  • Antiretroviral therapy research
  • Pharmacokinetics and drug safety

Background:

  • Tenofovir disoproxil fumarate (TDF) is a widely recommended first-line antiretroviral, approved for children aged 2+ and adolescents aged 10+.
  • Its efficacy against HIV and hepatitis B virus, once-daily dosing, and favorable metabolic profile make it suitable for large-scale programs.
  • Unlike other nucleoside reverse transcriptase inhibitors (NRTIs), TDF does not induce multi-NRTI resistance mutations, preserving future treatment options.

Purpose of the Study:

  • To review current information on the pharmacokinetics, safety, and tolerability of TDF in pediatric populations.
  • To establish a weight-band-based dosing regimen for pediatric use.
  • To inform clinical decision-making regarding the risks and benefits of TDF in children.

Main Methods:

  • Systematic review of existing clinical data on TDF in children and adolescents.
  • Analysis of pharmacokinetic and safety profiles.
  • Evaluation of established dosing regimens for pediatric use.

Main Results:

  • A body-weight-band dosing regimen for TDF has been established for pediatric use.
  • Key safety concerns include potential effects on renal function and bone mineral density.
  • Long-term data on renal and bone outcomes in HIV-infected children receiving TDF is still needed.

Conclusions:

  • TDF is a valuable antiretroviral agent for children and adolescents, with established dosing guidelines.
  • Regular monitoring of renal function is recommended for high-risk pediatric patients.
  • Further long-term studies are necessary to fully understand the renal and bone health implications of TDF in children.

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