Tenofovir nephrotoxicity among Asians living with HIV: review of the literature

Abstract

Tenofovir disoproxil fumarate (TDF), prodrug of tenofovir (TFV), is one of the most widely used nucleotide reverse transcriptase inhibitors (NRTIs) for the treatment of HIV infection in resource-rich and resourcelimited settings with proven efficacy and safety, and also for the treatment of hepatitis B infections. However, TDF can cause renal proximal tubular dysfunction and also reduces estimated glomerular filtration rate (eGFR) more than other NRTIs. To date, TDF-associated renal dysfunction is generally regarded as mild and tolerable. However, it is notable that low body weight is one of the risk factors for TFV nephrotoxicity and that Asians are generally of smaller body stature and can be susceptible to such nephrotoxicity, as shown in several cohort studies. Until tenofovir alafenamide (TAF), another prodrug of TFV with minimal renal toxicity, becomes widely accessible for people living with HIV and replaces TDF, it is warranted that physicians who prescribe TDF have a good understanding of TFV nephrotoxicity. This paper reviews recent literature on TFV nephrotoxicity among people living with HIV especially focusing on Asians who might be susceptible to TFV nephrotoxicity due to their lower body weight and discusses implications for clinical care and future directions.

A metabolic modeling approach reveals promising therapeutic targets and antiviral drugs to combat COVID-19

“…It is reasonable to expect that drugs targeting key human metabolic enzymes can be used to inhibit viral replication. Indeed, nucleoside and nucleotide analogs such as Tenofovir, Sofosbuvir or Ribavirin are already being used as antiviral drugs 6 – 8 . Pharmacological inhibition of either acetyl-CoA carboxylase (ACC) or fatty acid synthase (FASN) has also been shown to result in a strong reduction of viral titers in vaccinia infection 9 .…”

3D Spheroids of Human Primary Urine-Derived Stem Cells in the Assessment of Drug-Induced Mitochondrial Toxicity

“…As an NRTI, TFV has achieved therapeutic success for the treatment of HIV-1 infection. TFV has recently been reported with an increased risk of nephrotoxicity [ 85 ] despite no Mito-Tox induction in 2D cultures of HepG2 cells, human skeletal muscle cells, and renal proximal tubule epithelial cells [ 32 ], compared with other NRTIs. Another study showed that TFV achieves this independent of mtDNA depletion in HepG2 cell lines [ 51 ].…”

What is the role of microbial biotechnology and genetic engineering in medicine?

“…Viral diseases can be as benign as Therefore, drugs targeting key human metabolic enzymes can be used to inhibit viral replication. For example, nucleoside and nucleotide analogs such as Tenofovir, Sofosbuvir or Ribavirin are often used as antiviral drugs (Nishijima et al, 2019). Although the search for antivirals began with the successful isolation of small molecule-based compounds from microorganisms, such as certain antibiotics, almost all of the antiviral drug therapies currently in use are of chemical origin (Holmes et al, 1981;Velásquez et al, 2024).…”