Tenofovir alafenamide nephrotoxicity: a case report and literature review
Abstract Background Tenofovir alafenamide (TAF), a novel prodrug of tenofovir (TFV), has become the preferred drug for the treatment of HIV-1 and chronic hepatitis B infection in clinical practice. Results from clinical trials showed that it had better renal and bone mineral outcomes compared to ten...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | AIDS Research and Therapy |
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| Online Access: | https://doi.org/10.1186/s12981-021-00380-w |
| _version_ | 1818722063078129664 |
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| author | Thornthun Ueaphongsukkit Sivaporn Gatechompol Anchalee Avihingsanon Jerasit Surintrspanont Kroonpong Iampenkhae Yingyos Avihingsanon Suwasin Udomkarnjananun |
| author_facet | Thornthun Ueaphongsukkit Sivaporn Gatechompol Anchalee Avihingsanon Jerasit Surintrspanont Kroonpong Iampenkhae Yingyos Avihingsanon Suwasin Udomkarnjananun |
| author_sort | Thornthun Ueaphongsukkit |
| collection | DOAJ |
| description | Abstract Background Tenofovir alafenamide (TAF), a novel prodrug of tenofovir (TFV), has become the preferred drug for the treatment of HIV-1 and chronic hepatitis B infection in clinical practice. Results from clinical trials showed that it had better renal and bone mineral outcomes compared to tenofovir disoproxil fumarate (TDF). However, as we have seen with TDF, side effects from the new medication can be more prevalent and recognized after extensive use in real world situations. Sporadic cases of acute kidney injury in patients using TAF have started to emerge. Case presentation We report a case of 49-year-old Thai, HIV treatment-experienced female with hypertension presented with worsening renal function after switching her antiretroviral regimen from TDF, emtricitabine (FTC), and lopinavir/ritonavir (LPV/r) to TAF, FTC and dolutegravir (DTG) for 3 months. Kidney biopsy showed distinctive picture of tenofovir nephrotoxicity with acute tubular injury and mitochondrial injury. The possible causes of acute kidney injury and nephrotoxicity from TAF for this patient were discussed. We have extensively reviewed all published case reports of TAF-associated nephrotoxicity and summarized the essential information in this article. Conclusion Although TAF has less nephrotoxicity compared with TDF; renal function should always be monitored after the initiation of both drugs. Future large cohort studies are required to identify the risk factors of TAF-associated nephrotoxicity and to design an effective preventive strategy. |
| first_indexed | 2024-12-17T20:48:40Z |
| format | Article |
| id | doaj.art-afdae49bdc49466ca90611baf83a59a1 |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-12-17T20:48:40Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-afdae49bdc49466ca90611baf83a59a12022-12-21T21:33:06ZengBMCAIDS Research and Therapy1742-64052021-08-011811810.1186/s12981-021-00380-wTenofovir alafenamide nephrotoxicity: a case report and literature reviewThornthun Ueaphongsukkit0Sivaporn Gatechompol1Anchalee Avihingsanon2Jerasit Surintrspanont3Kroonpong Iampenkhae4Yingyos Avihingsanon5Suwasin Udomkarnjananun6Department of Medicine, Faculty of Medicine, Chulalongkorn UniversityThe HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research CentreThe HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research CentreDepartment of Pathology, Faculty of Medicine, Chulalongkorn UniversityDepartment of Pathology, Faculty of Medicine, Chulalongkorn UniversityDivision of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial HospitalDivision of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial HospitalAbstract Background Tenofovir alafenamide (TAF), a novel prodrug of tenofovir (TFV), has become the preferred drug for the treatment of HIV-1 and chronic hepatitis B infection in clinical practice. Results from clinical trials showed that it had better renal and bone mineral outcomes compared to tenofovir disoproxil fumarate (TDF). However, as we have seen with TDF, side effects from the new medication can be more prevalent and recognized after extensive use in real world situations. Sporadic cases of acute kidney injury in patients using TAF have started to emerge. Case presentation We report a case of 49-year-old Thai, HIV treatment-experienced female with hypertension presented with worsening renal function after switching her antiretroviral regimen from TDF, emtricitabine (FTC), and lopinavir/ritonavir (LPV/r) to TAF, FTC and dolutegravir (DTG) for 3 months. Kidney biopsy showed distinctive picture of tenofovir nephrotoxicity with acute tubular injury and mitochondrial injury. The possible causes of acute kidney injury and nephrotoxicity from TAF for this patient were discussed. We have extensively reviewed all published case reports of TAF-associated nephrotoxicity and summarized the essential information in this article. Conclusion Although TAF has less nephrotoxicity compared with TDF; renal function should always be monitored after the initiation of both drugs. Future large cohort studies are required to identify the risk factors of TAF-associated nephrotoxicity and to design an effective preventive strategy.https://doi.org/10.1186/s12981-021-00380-wTenofovir alafenamideAcute kidney injuryNephrotoxicityRenal pathologyMitochondriaHIV |
| spellingShingle | Thornthun Ueaphongsukkit Sivaporn Gatechompol Anchalee Avihingsanon Jerasit Surintrspanont Kroonpong Iampenkhae Yingyos Avihingsanon Suwasin Udomkarnjananun Tenofovir alafenamide nephrotoxicity: a case report and literature review AIDS Research and Therapy Tenofovir alafenamide Acute kidney injury Nephrotoxicity Renal pathology Mitochondria HIV |
| title | Tenofovir alafenamide nephrotoxicity: a case report and literature review |
| title_full | Tenofovir alafenamide nephrotoxicity: a case report and literature review |
| title_fullStr | Tenofovir alafenamide nephrotoxicity: a case report and literature review |
| title_full_unstemmed | Tenofovir alafenamide nephrotoxicity: a case report and literature review |
| title_short | Tenofovir alafenamide nephrotoxicity: a case report and literature review |
| title_sort | tenofovir alafenamide nephrotoxicity a case report and literature review |
| topic | Tenofovir alafenamide Acute kidney injury Nephrotoxicity Renal pathology Mitochondria HIV |
| url | https://doi.org/10.1186/s12981-021-00380-w |
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