Tenofovir Has Minimal Effect on Biomarkers of Bone Health in Youth with HIV Receiving Initial Antiretroviral Therapy.
Both HIV infection and tenofovir disoproxil fumarate (TDF) treatment adversely impact bone metabolism and may lead to osteopenia, which has critical implications for youth with HIV (YWH). This study evaluates changes in the biomarkers of bone metabolism and inflammation among YWH receiving initial treatment with TDF- and non-TDF-containing antiretroviral therapies (ARTs). YWH [n = 23, median age 21 years (range 18-24), 87% male, 61% African American] were assessed for inflammatory and bone metabolism biomarkers at enrollment, after 48 weeks of TDF-containing ART, and 96 weeks of ART without TDF with continued viral suppression. Spearman's rank correlation evaluated biomarker associations. Bone alkaline phosphatase, parathyroid hormone, and osteopontin increased after TDF treatment. All fell after TDF was discontinued. Levels of RANKL and osteoprotegerin did not change throughout the study. There was little correlation between biomarkers of bone metabolism and either macrophage or lymphocyte activation at any time point. Our results establish baseline associations between bone metabolism and immune biomarkers for this population, and find that before CD4 T cell decline chronic inflammation does not perturb biomarkers of bone metabolism among YWH. The adverse effects of TDF on bone health may be marginal for YWH at the early stages of disease.
['Kim-Chang|Julie J|JJ|', 'Wilson|Lorena|L|', 'Chan|Cliburn|C|', 'Fischer|Bernard|B|', 'Venturi|Guglielmo|G|', 'Goodenow|Maureen M|MM|', 'Aldrovandi|Grace|G|', 'Weber|Thomas J|TJ|', 'Sleasman|John W|JW|', '|||']
D000293:Adolescent D000469:Alkaline Phosphatase D019380:Anti-HIV Agents D015415:Biomarkers D015519:Bone Density D001851:Bone Diseases, Metabolic D001842:Bone and Bones D005260:Female D015658:HIV Infections D006801:Humans D008213:Lymphocyte Activation D008262:Macrophage Activation D008264:Macrophages D008297:Male D053495:Osteopontin D053244:Osteoprotegerin D010281:Parathyroid Hormone D053245:RANK Ligand D000068698:Tenofovir D055815:Young Adult
biomarker tenofovir disoproxil fumarate (TDF) bone metabolism youth with HIV (YWH) lymphocyte activation macrophage activation