Improved bone and renal safety in younger tenofovir disoproxil fumarate experienced chronic hepatitis B patients after switching to tenofovir alafenamide or entecavir

Wang, F D; Zhou, Jing; Li, Lan-Qing; Li, Yujing; Tao, Ya-Chao; Zhang, Dongmei; Wang, Yonghong; Chen, En‐Qiang

doi:10.1016/j.aohep.2023.101119

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Similarly, in patients with chronic hepatitis B infection, treatment with TDF was associated with lower BMD compared with controls and a more rapid decline in TDF compared with patients on entecavir [ 20 , 21 ]. In addition, switching patients with chronic hepatitis B infection and normal baseline BMD from TDF to entecavir or tenofovir alafenamide improved their BMD after 96 weeks [ 22 ]. These observations are especially worrying for older adults on TDF because they are already suffering from osteoporosis or are at high risk for fractures [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Tenofovir Disoproxil Fumarate on Bone Quality beyond Bone Density—A Scoping Review of the Literature

Hashwin Singh,

Jashwin Singh,

Chin

2024

Pharmaceuticals

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Tenofovir disoproxil fumarate (TDF) is a widely used pharmacological agent for the treatment of human immunodeficiency virus infection. While prolonged exposure to TDF has been associated with a decrease in bone mineral density (BMD) and increased fracture risk, limited discussion exists on its effects on various aspects of bone quality. This scoping review aims to provide a comprehensive overview of the impact of TDF on bone quality beyond BMD. A literature search was conducted using the PubMed and Scopus databases to identify studies investigating the effects of TDF on bone quality. Original research articles written in English, irrespective of study type or publication year, were included in the review. Seven articles met the inclusion criteria. Findings indicate that prolonged exposure to TDF adversely affects bone microarchitecture and strength, impeding fracture healing and skeletal microdamage repair. The observed effects suggest a complex interplay involving bone cell signalling, cytokines and bone remodelling processes as potential mechanisms underlying TDF’s impact on bone quality. As a conclusion, TDF impairs bone remodelling and microarchitecture by influencing dynamic bone cell behaviour and signalling pathways. Future studies should delve deeper into understanding the intricate negative effects of TDF on bone and explore strategies for reversing these effects.

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Section: Introductionmentioning

confidence: 99%

Effects of Tenofovir Disoproxil Fumarate on Bone Quality beyond Bone Density—A Scoping Review of the Literature

Hashwin Singh,

Jashwin Singh,

Chin

2024

Pharmaceuticals

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“…This greater disease burden has sometimes been attributed to the impact of ARTs on bone metabolism. Multiple studies, both on HIV and outside an HIV setting, found that tenofovir disoproxil fumarate (TDF)-containing ART regimens, but not tenofovir alafenamide (TAF), an alanine ester prodrug of TDF, led to greater bone loss, observed both in the spine and femur neck [5,[7][8][9][10][11][12][13][14]. Protease inhibitors (PIs) are also associated with greater bone loss, particularly in the lumbar spine, and may also increase fracture risk [1,5,8,[15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Bone Mineral Density and Trabecular Bone Score Changes throughout Menopause in Women with HIV

Milic,

Renzetti,

Morini

et al. 2023

Viruses

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Objective: The objectives of this study were to describe the trajectories of bone mineral density (BMD) and trabecular bone score (TBS) changes throughout pre-menopause (reproductive phase and menopausal transition) and post-menopause (early and late menopause) in women with HIV (WWH) undergoing different antiretroviral therapies (ARTs) and explore the risk factors associated with those changes. Methods: This was an observational longitudinal retrospective study in WWH with a minimum of two DEXA evaluations comprising BMD and TBS measurements, both in the pre-menopausal and post-menopausal periods. Menopause was determined according to the STRAW+10 criteria, comprising four periods: the reproductive period, menopausal transition, and early- and late-menopausal periods. Mixed-effects models were fitted to estimate the trajectories of the two outcomes (BMD and TBS) over time. Annualized lumbar BMD and TBS absolute and percentage changes were calculated in each STRAW+10 time window. A backward elimination procedure was applied to obtain the final model, including the predictors that affected the trajectories of BMD or TBS over time. Results: A total of 202 WWH, all Caucasian, were included. In detail, 1954 BMD and 195 TBS data were analyzed. The median number of DEXA evaluations per woman was 10 (IQR: 7, 12). The median observation periods per patient were 12.0 years (IQR = 8.9–14.4) for BMD and 6.0 years (IQR: 4.3, 7.9) for TBS. The prevalence of osteopenia (63% vs. 76%; p < 0.001) and osteoporosis (16% vs. 36%; p < 0.001) increased significantly between the pre-menopausal and post-menopausal periods. Both BMD (1.03 (±0.14) vs. 0.92 (±0.12) g/cm2; p < 0.001) and TBS (1.41 (IQR: 1.35, 1.45) vs. 1.32 (IQR: 1.28, 1.39); p < 0.001) decreased significantly between the two periods. The trend in BMD decreased across the four STRAW+10 periods, with a slight attenuation only in the late-menopausal period when compared with the other intervals. The TBS slope did not significantly change throughout menopause. The delta mean values of TBS in WWH were lower between the menopausal transition and reproductive period compared with the difference between menopause and menopausal transition. Conclusions: Both BMD and TBS significantly decreased over time. The slope of the change in BMD and TBS significantly decreased in the menopausal transition, suggesting that this period should be considered by clinicians as a key time during which to assess bone health and modifiable risk factors in WWH.

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Efficacy and Safety of Tenofovir Amibufenamide and Tenofovir Alafenamide for First‐Time HBV‐Related Decompensated Cirrhosis

Rong,

Yang,

et al. 2024

Journal of Viral Hepatitis

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Clinical studies of tenofovir amibufenamide (TMF) and tenofovir alafenamide (TAF) treatment in patients with HBV‐related decompensated cirrhosis (HBV‐DC) are limited. This study evaluated the efficacy and safety of TMF versus TAF in naive‐treated patients with first‐time HBV‐DC. Based on the antiviral drug used, patients were categorised into the TMF group and the TAF group. Virological and serological responses, hepatic and renal functions and blood lipid changes in both groups were evaluated during 48 weeks of treatment. A total of 98 patients were enrolled, 45 in the TMF group and 53 in the TAF group. At 48 weeks of treatment, the proportions of patients who achieved complete virological response (CVR) were 85.7% and 90.7%, respectively (p = 0.791). Improvement of at least 2 points in Child–Turcotte–Pugh scores was observed in 64.3% versus 79.1% (p = 0.169) of the patients. There were no significant changes in serum creatinine, estimated glomerular filtration rate or total cholesterol from baseline to week 48 between the two groups. Cystatin C remained stable in the TMF group but increased over time in the TAF group (p < 0.001). Low‐density lipoprotein cholesterol remained stable in the TMF group but increased significantly in the TAF group at week 48 (p = 0.015). These results suggest that both TMF and TAF can rapidly suppress HBV replication, improve hepatic function and have no negative effects on renal function among patients with HBV‐DC. Regarding lipid metabolism, both showed a better safety, while regular monitoring of blood lipid levels is recommended.

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Improved bone and renal safety in younger tenofovir disoproxil fumarate experienced chronic hepatitis B patients after switching to tenofovir alafenamide or entecavir

Cited by 4 publications

References 28 publications

Effects of Tenofovir Disoproxil Fumarate on Bone Quality beyond Bone Density—A Scoping Review of the Literature

Effects of Tenofovir Disoproxil Fumarate on Bone Quality beyond Bone Density—A Scoping Review of the Literature

Bone Mineral Density and Trabecular Bone Score Changes throughout Menopause in Women with HIV

Efficacy and Safety of Tenofovir Amibufenamide and Tenofovir Alafenamide for First‐Time HBV‐Related Decompensated Cirrhosis

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