ArticleClinical rheumatology2016
Hypophosphatemic osteomalacia induced by tenofovir in HIV-infected patients.
Article in Clinical rheumatology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 77 citations in OpenAlex.
- Effect of high-dose cholecalciferol (vitamin DOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Trial
- Real-world pharmacovigilance of drug-related bone metabolism disorders: integrating FAERS and VigiAccess with a Bradford Hill-based causal plausibility assessment.Frontiers in pharmacology · 2026Article
- Effects of tenofovir alafenamide fumarate on serum lipid profiles in patients with chronic hepatitis B.Virology journal · 2024Article
- Global guidance for the recognition, diagnosis, and management of tumor-induced osteomalacia.Journal of internal medicine · 2023Review
- Approach to Hypophosphatemic Rickets.The Journal of clinical endocrinology and metabolism · 2022Article
- Bilateral symmetrical stress fractures of femoral neck in HIV patient: case report and brief review of literature.BJR case reports · 2022Article
- Secondary Osteoporosis and Metabolic Bone Diseases.Journal of clinical medicine · 2022Review
- Impact of hypogonadism on bone mineral density and vertebral fractures in HIV-infected men.Journal of endocrinological investigation · 2022Article
- Real-World Single-Center Comparison of the Safety and Efficacy of Entecavir, Tenofovir Disoproxil Fumarate, and Tenofovir Alafenamide in Patients with Chronic Hepatitis B.Intervirology · 2022Article
- Fanconi Syndrome Leading to Hypophosphatemic Osteomalacia Related to Tenofovir Use.Infectious disease reports · 2021Article
- Tenofovir-induced osteomalacia with hypophosphataemia.BMJ case reports · 2021Article
- A novel evidence of serial changes of bone mineral density in chronic hepatitis B patients treated with entecavir.Hepatology international · 2021Article
- Role of Phosphate in Biomineralization.Calcified tissue international · 2021Review
- The Causes of Hypo- and Hyperphosphatemia in Humans.Calcified tissue international · 2021Review
- Incapacitating pain from Tenofovir Induced Hypophosphatemic Osteomalacia in a Hemophilia Patient - A Case Report.Canadian journal of pain = Revue canadienne de la douleur · 2020Article
- X-Linked Hypophosphatemia: A New Era in Management.Journal of the Endocrine Society · 2020Review
- Efficacy and safety of lower dose tenofovir disoproxil fumarate and efavirenz versus standard dose in HIV-infected, antiretroviral-naive adults: a multicentre, randomized, noninferiority trial.Emerging microbes & infections · 2020Article
- Molecular Control of Phosphorus Homeostasis and Precision Treatment of Hypophosphatemic Disorders.Current molecular biology reports · 2019Article
- Tenofovir disoproxil fumarate may not cause renal and bone toxicity in chronic hepatitis B patients: a retrospective cross-sectional studyTurkish journal of medical sciences · 2019Article
- Endocrinological aspects of HIV infection.Journal of endocrinological investigation · 2018Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tenofovir disoproxil fumarate (TDF) is an adenine analogue reverse transcription inhibitor widely used in first-line treatment of human immunodeficiency virus (HIV) infection and also in hepatitis B virus infection. Its use has been linked to sporadic Fanconi syndrome, renal failure and bone disease. We present the clinical characteristics of tenofovir-induced osteomalacia, discuss bone biopsy findings, describe predisposing factors and compare our results with other reported cases. We describe five cases of hypophosphatemic osteomalacia induced by TDF and recorded at the rheumatology service of a university hospital between 2010 and 2014. We also report the characteristics of bone biopsies of this pathology, which have not been previously described. We include a review of published cases of proximal renal tubulopathy (PRT) and osteomalacia induced by TDF (PubMed 1995-2014; keywords: osteomalacia, tenofovir, Fanconi syndrome, hypophosphatemic osteomalacia, proximal renal tubulopathy, bone biopsy). Five HIV patients who developed hypophosphatemic osteomalacia under TDF treatment (>5 years) presented increasing bone pain and a progressive inability to walk without assistance as a result of multiple insufficiency fractures. Bone biopsy performed in three patients after tetracycline labelling showed increased osteoid thickness, confirming osteomalacia. A literature review retrieved 17 publications on this condition, including 53 cases: 26 patients developed isolated PRT, 25 presented PRT and with multiple insufficiency fractures and two presented isolated bone disease, including osteomalacia and osteoporosis. Rheumatologists should be alert to this complication in patients receiving tenofovir. The main complaint reported by these patients is diffuse pain, predominantly in the lower limbs, indicating multiple stress fractures. Serum phosphate and appropriate screening for abnormal proximal tubule function should be monitored. Bone scintigraphy should be carried out in cases of limb pain before the occurrence of more severe complications.
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