Impact of Tenofovir-Based Pre-exposure Prophylaxis on Biomarkers of Bone Formation, Bone Resorption, and Bone Mineral Metabolism in HIV-Negative Adults

摘要: Background Pre-exposure prophylaxis (PrEP) with emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) reduces the risk of HIV seroconversion but may promote bone mineral density (BMD) decline. The mechanisms BMD decline FTC/TDF remain unclear, and studies in HIV-positive individuals have been confounded by effects concomitant antiretroviral medications. We evaluated impact on biomarkers remodeling metabolism HIV-negative men women enrolled Partners PrEP Study. Methods In a random sample participants randomized to (n = 50) or placebo 50), serum parathyroid hormone (PTH), (C-telopeptide, procollagen 1 intact N-terminal propeptide, sclerostin), plasma fibroblast growth factor 23 were measured at baseline month 24, percentage change was compared between groups. complementary analysis, we without 25% glomerular filtration rate (GFR) FTC/TDF. Results Baseline characteristics similar groups (median age, 38 years; 40% women). Vitamin D insufficiency common, GFR PTH normal range. observed significantly greater percent increase C-telopeptide vs (P .03), suggesting an remodeling. no differences other biomarkers, separate analysis comparing GFR. Conclusions Increased mediate tenofovir-containing therapy, independent TDF-mediated decrease kidney function.