Tenofovir-Linked Hyperparathyroidism Is Independently Associated With the Presence of Vitamin D Deficiency

Abstract

25(OH) VDD is associated with tenofovir-linked hyperparathyroidism and also with higher eGFR.

Antimicrobial implications of vitamin D

“…63 Moreover, nonnucleoside reverse transcriptase inhibitor and protease inhibitor treatment puts patients at risk of elevated parathyroid hormone levels, 63 as shown with tenofovirlinked hyperparathyroidism, which is closely linked to vitamin D deficiency. 69 However, vitamin D status did not affect CD4 cell recovery after initiation of highly active antiretroviral therapy. 63 Host defense against human T-lymphotropic virus type 1 (HTLV-1) hinges on an effective Th1 response.…”

Association of Higher Plasma Vitamin D Binding Protein and Lower Free Calcitriol Levels with Tenofovir Disoproxil Fumarate Use and Plasma and Intracellular Tenofovir Pharmacokinetics: Cause of a Functional Vitamin D Deficiency?

“…The phosphaturic hormone fibroblast growth factor 23 (FGF23) is not altered by TDF use (18,19). TDFassociated bone changes may occur through a TDF effect on parathyroid hormone (16,20), as parathyroid hormone secretion increases soon after initiating TDF (21). Vitamin D deficiency (22) may exacerbate this increase in parathyroid hormone (20,23), but TDF-associated increased parathyroid hormone is found even in persons with sufficient vitamin D (24).…”

Vitamin D deficiency in HIV-infected patients: a systematic review

“…42,60 In some studies designed for the purpose, PTH concentration or prevalence of sHPTH was found to be consistently associated with 25OHD level and/or ART therapy (PIs and NNRTIs). 7,34,36,[39][40][41][42]45,51 Three articles, in particular, found a correlation between tenofovir use and higher parathyroid hormone concentrations. 7,36,39 In addition, Masia et al evaluated changes in PTH after the initiation of two different ART regimens.…”

“…7,34,36,[39][40][41][42]45,51 Three articles, in particular, found a correlation between tenofovir use and higher parathyroid hormone concentrations. 7,36,39 In addition, Masia et al evaluated changes in PTH after the initiation of two different ART regimens. 7 Both regimens produced significant increases in PTH concentration, and in the proportion of patients presenting with sHPTH during the follow-up period.…”

“…7,8,36,[39][40][41][42][43][44][45]47,48,50,51 None of these was a casecontrol study comparing the frequency of this condition between HIV+ and healthy controls. The reported frequency of sHPTH at baseline varied from 0% to 33%.…”