HIV PrEP in teens: significant BMD changes, but renal function unaffected

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Takeaway

  • Teens who wish to take tenofovir/emtricitabine (Truvada) for HIV prevention should be followed carefully for bone mineral density (BMD) effects.

Why this matters                                                                             

  • Tenofovir (Viread) is known to worsen renal function and decrease bone density in adults, but little information is available on teens.

Key results

  • BMD declined significantly at 24 and 48 wk.
  • 2 participants sustained fractures during study period after trauma.
  • BMD declines were more pronounced among people with high levels of drug exposure, especially in total hip BMD.
  • BMD changes were correlated with drug concentrations at 12 wk, 24 wk, and 48 wk.
  • Estimated glomerular filtration rate and other markers of renal function did not change significantly during study.
  • Despite lack of changes to serum creatinine or eGFR, endocrine markers changed significantly by 8 wk in the high-adherence group.

Study design

  • Subanalysis of randomized controlled trial.
  • 101 young men who have sex with men without HIV enrolled in the ATN 117 study.
  • Funding: NIH.

Limitations

  • Sample size is modest, limiting the power of these findings.
  • Number of participants with significant drug concentrations was small.