Decreased Bone Mineral Density with Off-Label Use of Tenofovir in Children and Adolescents Infected with Human Immunodeficiency Virus

An abstract of this study was presented at the 14th Conference on Retroviruses and Opportunistic Infections, February 25-28, 2007, in Los Angeles, California.

Received 18 July 2007; received in revised form 19 October 2007; accepted 11 December 2007.

5 of 6 children infected with human immunodeficiency virus (HIV) receiving Tenofovir disoproxil fumarate (TDF) experienced absolute decreases in bone mineral density (BMD). 2 pre-pubertal subjects experienced >6% BMD decreases. 1 subject was the smallest child and experienced a 27% decrease, necessitating withdrawal of TDF. Subsequently, her BMD recovered. Monitoring of children infected with HIV who require treatment with TDF is warranted.

Abbreviations: BMD, Bone mineral density, DXA, Dual-energy x-ray absorptiometry, HAART, Highly active antiretroviral therapy, HIV, Human immunodeficiency virus, TDF, Tenofovir disoproxil fumarate

a HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD

b Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD

c Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD

d Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD

e Pediatric Adolescent and Maternal AIDS Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.

Reprint requests: Rohan Hazra, MD, Pediatric Adolescent and Maternal AIDS Branch, National Institute of Child Health and Human Development, 6100 Executive Boulevard, Room 4B11, Bethesda, MD 20892-7510.

Supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Center for Cancer Research.

PII: S0022-3476(07)01166-3

doi:10.1016/j.jpeds.2007.12.020

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