Tenofovir Nephrotoxicity: 2011 Update

Fernández-Fernández, Beatriz; Montoya-Ferrer, Ana; Sanz, Ana B.; Sánchez-Niño, María D.; Izquierdo, María C.; Poveda, Jonay; Sainz-Prestel, Valeria; Ortíz-Martín, Natalia; Parra-Rodríguez, Alejandro; Selgas, Rafael; Ruíz-Ortega, Marta; Egido, Jesús; Ortíz, Alberto

doi:10.1155/2011/354908

Cited by 204 publications

(282 citation statements)

References 75 publications

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“…Adverse events of tenofovir treatment was reported in clinical studies as nausea; headache; nasopharyngitis; fatigue; abdominal and back pain; increase of ALT, AST, serum amylase, serum creatinine, and serum creatine kinase (34,35).…”

Section: Discussionmentioning

confidence: 99%

Tenofovir–best hope for treatment of chronic hepatitis B infection?

Örmeci

Özbaş²,

Güner³

et al. 2015

Turk J Gastroenterol

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Background/Aims: To evaluate the effectiveness of tenofovir in patients with chronic hepatitis B infection in a real life setting. Materials and Methods: We performed a retrospective analysis of data from 164 patients with chronic hepatitis B who were treated with Tenofovir. Eighty-six patients (52.4%) were naïve. Seventy-seven (46.9%) patients were previously treated with anti-viral drugs, including standard interferon (n=4), pegylated (PEG) interferon (n=14), standard interferon together with lamivudine (n=13), lamivudine alone (n=41), adefovir (n=2), lamivudine together with adefovir (n=1), and entecavir (n=2). Six patients (3.7%) had liver cirrhosis before treatment of tenofovir. Results: The patients who have hepatitis B viral DNA>104 copy/mL with chronic hepatitis B infection were included in the treatment of Tenofovir. Average follow up time was 30.31±14.33 months. HBV DNA negativity and alanine aminotransferase (ALT) normalization were 86.5% and 71.3%, respectively, at the last visit. Hepatitis B e-Antigen (HBeAg) seroconversion occurred in 11 (19.6%) out of 164 patients. During the follow-up period, 4 (2.4%) patients developed liver cirrhosis and in 5 (3%) patients hepatocellular carcinoma (HCC) occurred out of 164 patients. HBsAg seroconversion occurred in one patient (0.6%). Conclusion: Tenofovir can be used safely and successfully in those patients that were naive, experienced with immune modulators and/or antivirals, HBeAg-positive, and HBeAg-negative patients.

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Section: Discussionmentioning

confidence: 99%

Tenofovir–best hope for treatment of chronic hepatitis B infection?

Örmeci

Özbaş²,

Güner³

et al. 2015

Turk J Gastroenterol

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“…Paediatric data on TDF renal toxicity are also controversial, showing conflicting results from no renal dysfunction to increased rates of proteinuria and hypophosphataemia 124. Extrapolating from adult studies showing that renal dysfunction is associated with increased TDF plasma levels and PI use 125, dosing accuracy and meticulous attention to monitoring for renal dysfunction in children, especially in those who are on concomitant PIs, are of particular importance.…”

Section: Drug Toxicities and Interactionsmentioning

confidence: 99%

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

et al. 2015

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The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV‐1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short‐term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long‐term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first‐ and second‐line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART ‘pipeline’ of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained.

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“…Proximal tubular dysfunction causes a partial or complete Fanconi syndrome with metabolic acidosis and increased phosphate loss, both of which contribute to bone demineralisation. Tenofovir also reduces calcitriol synthesis in proximal tubular mitochondria, contributing to bone demineralisation [41]. BMD decline begins after 12-24 weeks and has been noted after up to 144 weeks on therapy.…”

Section: Discussionmentioning

confidence: 99%