The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity.
Tenofovir has been associated with renal phosphate wasting, reduced bone mineral density, and higher parathyroid hormone levels. The aim of this study was to carry out a detailed comparison of the effects of tenofovir versus non-tenofovir use on calcium, phosphate and, vitamin D, parathyroid hormone...
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| Format: | Article |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3440360?pdf=render |
| _version_ | 1819066105697665024 |
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| author | Karen Klassen Adrian R Martineau Robert J Wilkinson Graham Cooke Alan P Courtney Mary Hickson |
| author_facet | Karen Klassen Adrian R Martineau Robert J Wilkinson Graham Cooke Alan P Courtney Mary Hickson |
| author_sort | Karen Klassen |
| collection | DOAJ |
| description | Tenofovir has been associated with renal phosphate wasting, reduced bone mineral density, and higher parathyroid hormone levels. The aim of this study was to carry out a detailed comparison of the effects of tenofovir versus non-tenofovir use on calcium, phosphate and, vitamin D, parathyroid hormone (PTH), and bone mineral density.A cohort study of 56 HIV-1 infected adults at a single centre in the UK on stable antiretroviral regimes comparing biochemical and bone mineral density parameters between patients receiving either tenofovir or another nucleoside reverse transcriptase inhibitor.In the unadjusted analysis, there was no significant difference between the two groups in PTH levels (tenofovir mean 5.9 pmol/L, 95% confidence intervals 5.0 to 6.8, versus non-tenofovir; 5.9, 4.9 to 6.9; p = 0.98). Patients on tenofovir had significantly reduced urinary calcium excretion (median 3.01 mmol/24 hours) compared to non-tenofovir users (4.56; p<0.0001). Stratification of the analysis by age and ethnicity revealed that non-white men but not women, on tenofovir had higher PTH levels than non-white men not on tenofovir (mean difference 3.1 pmol/L, 95% CI 5.3 to 0.9; p = 0.007). Those patients with optimal 25-hydroxyvitamin D (>75 nmol/L) on tenofovir had higher 1,25-dihydroxyvitamin D [1,25(OH)(2)D] (median 48 pg/mL versus 31; p = 0.012), fractional excretion of phosphate (median 26.1%, versus 14.6; p = 0.025) and lower serum phosphate (median 0.79 mmol/L versus 1.02; p = 0.040) than those not taking tenofovir.The effects of tenofovir on PTH levels were modified by sex and ethnicity in this cohort. Vitamin D status also modified the effects of tenofovir on serum concentrations of 1,25(OH)(2)D and phosphate. |
| first_indexed | 2024-12-21T15:57:04Z |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T15:57:04Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-74fc12414f5c4041b374022557e9c4412022-12-21T18:58:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4484510.1371/journal.pone.0044845The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity.Karen KlassenAdrian R MartineauRobert J WilkinsonGraham CookeAlan P CourtneyMary HicksonTenofovir has been associated with renal phosphate wasting, reduced bone mineral density, and higher parathyroid hormone levels. The aim of this study was to carry out a detailed comparison of the effects of tenofovir versus non-tenofovir use on calcium, phosphate and, vitamin D, parathyroid hormone (PTH), and bone mineral density.A cohort study of 56 HIV-1 infected adults at a single centre in the UK on stable antiretroviral regimes comparing biochemical and bone mineral density parameters between patients receiving either tenofovir or another nucleoside reverse transcriptase inhibitor.In the unadjusted analysis, there was no significant difference between the two groups in PTH levels (tenofovir mean 5.9 pmol/L, 95% confidence intervals 5.0 to 6.8, versus non-tenofovir; 5.9, 4.9 to 6.9; p = 0.98). Patients on tenofovir had significantly reduced urinary calcium excretion (median 3.01 mmol/24 hours) compared to non-tenofovir users (4.56; p<0.0001). Stratification of the analysis by age and ethnicity revealed that non-white men but not women, on tenofovir had higher PTH levels than non-white men not on tenofovir (mean difference 3.1 pmol/L, 95% CI 5.3 to 0.9; p = 0.007). Those patients with optimal 25-hydroxyvitamin D (>75 nmol/L) on tenofovir had higher 1,25-dihydroxyvitamin D [1,25(OH)(2)D] (median 48 pg/mL versus 31; p = 0.012), fractional excretion of phosphate (median 26.1%, versus 14.6; p = 0.025) and lower serum phosphate (median 0.79 mmol/L versus 1.02; p = 0.040) than those not taking tenofovir.The effects of tenofovir on PTH levels were modified by sex and ethnicity in this cohort. Vitamin D status also modified the effects of tenofovir on serum concentrations of 1,25(OH)(2)D and phosphate.http://europepmc.org/articles/PMC3440360?pdf=render |
| spellingShingle | Karen Klassen Adrian R Martineau Robert J Wilkinson Graham Cooke Alan P Courtney Mary Hickson The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity. PLoS ONE |
| title | The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity. |
| title_full | The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity. |
| title_fullStr | The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity. |
| title_full_unstemmed | The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity. |
| title_short | The effect of tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity. |
| title_sort | effect of tenofovir on vitamin d metabolism in hiv infected adults is dependent on sex and ethnicity |
| url | http://europepmc.org/articles/PMC3440360?pdf=render |
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