Bone outcomes in virally suppressed youth with HIV switching to tenofovir disoproxil fumarate
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | Bone outcomes in virally suppressed youth with HIV switching to tenofovir disoproxil fumarate | |
| Creator | Braithwaite, Kate McPherson, Tristan D. Shen, Yanhan Arpadi, Stephen Shiau, Stephanie Sorour, Gillian Technau, Karl-Günter Yin, Michael T. | |
| Description | Background: Tenofovir disoproxil fumarate (TDF) is included in first-line antiretroviral treatment (ART) for adolescents living with HIV (ALWH). Associated toxicities remain a concern.Objective: We evaluated bone and renal safety outcomes in virologically suppressed South African ALWH after switching to TDF.Method: We recruited virally suppressed ( 100 copies/mL) adolescents, aged 15–20 years, who switched from an abacavir (ABC)-based to a TDF-based efavirenz regimen. Bone mass and renal function were assessed at Week 0 and at Week 24 after the switch to TDF using dual-energy X-ray absorptiometry (DXA) and serum renal markers. A change in the lumbar spine (LS) and the whole-body less head (WBLH) bone mineral density (BMD) Z-scores and the estimated glomerular filtration rate (eGFR) between the two measures were compared (paired t-tests) and stratified by sex.Results: Fifty participants (48% male), with a median duration of prior ART of 11.4 years, were enrolled. Among 47 participants with 24-week DXA results, 15 (32%) had either no change or a decreased LS-BMD after the switch, with a mean change of –1.6%. Overall, more female participants experienced this outcome: 58% versus 4%, P 0.0001. The mean change (standard deviation) in the LS-Z-score was –0.03 (0.25) and in the WBLH-Z-score was 0.02 (0.24). A decrease in the eGFR from 132.2 to 120.4 was observed (P = 0.0003); however, the levels remained clinically acceptable.Conclusion: South African ALWH switching from abacavir to TDF-based ART experienced statistically significant decreases in eGFR but not in LS and WBLH BMD. Female ALWH were more likely to experience a decrease in LS-BMD and may require closer monitoring. | |
| Publisher | AOSIS | |
| Date | 2021-08-05 | |
| Identifier | 10.4102/sajhivmed.v22i1.1243 | |
| Source | Southern African Journal of HIV Medicine; Vol 22, No 1 (2021); 8 pages 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/1243/2476
https://sajhivmed.org.za/index.php/hivmed/article/view/1243/2477
https://sajhivmed.org.za/index.php/hivmed/article/view/1243/2478
https://sajhivmed.org.za/index.php/hivmed/article/view/1243/2479
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