- Category: Bone Loss
- Published on Tuesday, 18 March 2014 00:00
- Written by Gregory Fowler
Infants born to women who took tenofovir during pregnancy had significantly lower bone mineral content than babies who were not exposed, according to study findings reported at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) this month in Boston.
[Geroge Siberry, CROI press conference, March 5, 2014]
Tenofovir (Viread, also in the
Truvada, Atripla, Complera, and Stribild coformulations) is known to be associated with a small amount of bone loss soon after starting antiretroviral therapy (ART) in HIV positive adults. Its effect on infants has previously not been extensively studied. U.S. and World Health Organization guidelines both recommend tenofovir-containing ART for pregnant women with HIV.
George Siberry from the National Institute of Child Health and Human Developmentand colleagues looked at 74 infants in the U.S. exposed to tenofovir for at least 8 weeks and 69 infants not exposed at all to tenofovir. About two-thirds of the pregnant women were black, a majority also used ritonavir-boosted protease inhibitors, and about one-third reported alcohol or drug use. Most had low or undetectable viral load (<400 copies/mL).
Tenofovir-exposed infants had significantly lower average whole-body bone mineral content compared with unexposed babies, 56.0 vs 63.8 grams, respectively. Bone content remained lower after adjusting for factors including infant gestational age, infant size, and maternal age, protease inhibitor use, and smoking. The infants' gestational age, length, and weight did not differ according to tenofovir exposure.
The persistence or long-term progression of reduced bone content in exposed infants is not yet clear. "The duration and clinical significance of this finding merit evaluation in longitudinal studies," the researchers concluded.
GK Siberry, DL Jacobson, H Kalkwarf, et al. Lower Newborn Bone Mineral Content Associated With Maternal Use of Tenofovir Disoproxil Fumarate. 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014). Boston, March 3-6. Abstract 71.