Original Research

Bone turnover markers in HIV-infected women on tenofovir-based antiretroviral therapy

Mwila Mulubwa, Michelle Viljoen, Iolanthe M. Kruger, Herculina S. Kruger, Malie Rheeders
Southern African Journal of HIV Medicine | Vol 18, No 1 | a739 | DOI: https://doi.org/10.4102/sajhivmed.v18i1.739 | © 2017 Mwila Mulubwa, Michelle Viljoen, Iolanthe M. Kruger, Herculina S. Kruger, Malie Rheeders | This work is licensed under CC Attribution 4.0
Submitted: 08 February 2017 | Published: 06 December 2017

About the author(s)

Mwila Mulubwa, Centre of Excellence for Pharmaceutical Sciences (Pharmacen), Division of Pharmacology, North-West University, South Africa
Michelle Viljoen, Centre of Excellence for Pharmaceutical Sciences (Pharmacen), Division of Pharmacology, North-West University, South Africa; Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, South Africa
Iolanthe M. Kruger, Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, South Africa
Herculina S. Kruger, Centre of Excellence for Nutrition (CEN), North-West University, South Africa; Medical Research Council Hypertension and Cardiovascular Disease Research Unit, North-West University, South Africa
Malie Rheeders, Centre of Excellence for Pharmaceutical Sciences (Pharmacen), Division of Pharmacology, North-West University, South Africa


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Abstract

Background: Tenofovir disoproxil fumarate (TDF) antiretroviral therapy is associated with disruption of the bone turnover process.

Objectives: The objective of this study was to determine the association between tenofovir (TFV) plasma concentration and various bone turnover markers and compare these markers in HIV-infected women and HIV-uninfected controls.

Method: A cross-sectional sub-study included 30 HIV-infected women on TDF and 30 HIV-uninfected matched participants. Serum calcium (SrCa), serum phosphate (SrP), C-terminal telopeptide (CTx), parathyroid hormone (PTH), alkaline phosphatase (ALP), C-reactive protein (CRP), vitamin D (VitD) and bone mineral density (BMD) were measured. Plasma TFV was assayed on HPLC-MS/MS. The statistical tests applied were Mann–Whitney test, unpaired t-test, analysis of covariance, regression and correlation analysis.

Results: In HIV-infected women, no correlation existed between plasma TFV concentration and CTx, PTH, ALP, SrCa, SrP, VitD or BMD (p > 0.05). After adjusting for smoking and alcohol use, ALP (p < 0.001), CTx (p = 0.027) and PTH (p = 0.050) were significantly higher in HIV-infected compared to HIV-uninfected women. Women with TFV concentration ≥ 120 ng/mL had higher PTH concentrations (p = 0.037) compared to those with ≤ 100 ng/mL. Significant correlations between SrCa and PTH and SrCa and SrP including CTx and PTH (p < 0.05) were present in HIV-uninfected women while absent in HIV-infected counterparts (p > 0.05).

Conclusion: The results indicate possible increased bone turnover at higher TFV concentrations. The normal regular bone turnover processes in HIV-infected women on TDF therapy are altered. Larger studies are warranted to confirm these results.


Keywords

Tenofovir levels; Bone turnover markers; Female HIV-infected

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Crossref Citations

1. Differences between bone mineral density, lean and fat mass of HIV-positive and HIV-negative black women
C Ellis, HS Kruger, P Ukegbu, IM Kruger, M Viljoen, MC Kruger
Journal of Endocrinology, Metabolism and Diabetes of South Africa  vol: 24  issue: 2  first page: 50  year: 2019  
doi: 10.1080/16089677.2019.1589047