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Tenofovir-induced Fanconi syndrome and osteomalacia in two HIV-infected patients: Role of intracellular tenofovir diphosphate levels and review of the literature

2011; Informa; Volume: 43; Issue: 10 Linguagem: Inglês

10.3109/00365548.2011.577805

1651-1980

Milly Haverkort, Bas W. van der Spek, P. Lips, Walentina A. T. Slieker, Rob ter Heine, Alwin D. R. Huitema, W Bronsveld,

Pharmacological Effects and Toxicity Studies

We present 2 human immunodeficiency virus-infected patients with tenofovir disoproxil fumarate-induced Fanconi syndrome, leading to osteomalacia. Intracellular tenofovir diphosphate levels were measured in 1 patient and were found to be very high, with plasma tenofovir levels just slightly elevated. Fibroblast growth factor-23, a phosphaturic hormone, was decreased in both patients and is therefore unlikely to have a pathophysiological role in this pathology. The different potential factors contributing to the development of tenofovir-related kidney proximal tubular dysfunction are discussed and the data presented may help to further elucidate its pathogenesis.