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Jul 23, 2007

hi there my question is regarding the drug tenofovir. I have heard that it can cause bone problems as well as kidney failure. how common is this. also, couldn't someone just take calcium and magnesium supplements to counter this?

thank you

Response from Dr. Wohl

Tenofovir is a potent and useful HIV medication. It has been studied in lots of people and is included in Truvada and Atripla.

There are data that indicate tenofovir can lead to slight loss of bone density. In clinical trials, people receiving tenofovir and those on a non-tenofovir containing regimen both lost some bone density over the course of the study but the loss was more with tenofovir. The good news was the change was fairly small and reached a plateau after which there was no further loss of bone density.

There has been extensive study of the effects of tenofovir on kidney function. The drug can cause a decline in renal function over time. For most, this is a minor change that is not clinically significant. However, others experience a more significant drop in kidney filtering ability. It is hard to predict who will develop more trouble with tenofovir so it is best that patients on the drug have their kidney function monitored using data from standard blood tests.

Calcium supplementation is worthwhile for many people. HIV+ persons who are thin or have been thin, have more advanced HIV disease, smoke or drink heavily or have been on corticosteroids (like prednisone) should consider getting a bone density scan. Those with bones that are not as dense as they should be can receive calcium and vitamin D (helps calcium work). In more severe cases, drugs like Fosamax may be needed. There are no supplements that are known to be helpful in protecting the kidneys from the effects of tenofovir.


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