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

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 0.05). 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 result