Antiviral Therapy 13:1077–1082
Short communication Tenofovir use is associated with an increase in serum alkaline phosphatase in the Swiss HIV Cohort Study Christoph A Fux1*, Andri Rauch1, Mathew Simcock 2,3, Heiner C Bucher 2,3, Bernard Hirschel 4, Milos Opravil5, Pietro Vernazza6, Matthias Cavassini 7, Enos Bernasconi 8, Luigia Elzi 3, Hansjakob Furrer1 and the Swiss HIV Cohort Study Division of Infectious Diseases, University Hospital Berne and University of Berne, Berne, Switzerland Basel Institute for Clinical Epidemiology, Basel, Switzerland 3 Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland 4 Geneva University Hospital, Geneva, Switzerland 5 University Hospital Zürich, Zürich, Switzerland 6 Kantonsspital St Gallen, St Gallen, Switzerland 7 Centre Universitaire Hospitalier Vaudois, Lausanne, Switzerland 8 Hospital Civico Lugano, Lugano, Switzerland 1 2
*Corresponding author: E-mail:
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Background: Tenofovir (TDF) use has been associated with proximal renal tubulopathy, reduced calculated glomerular filtration rates (cGFR) and losses in bone mineral density. Bone resorption could result in a compensatory osteoblast activation indicated by an increase in serum alkaline phosphatase (sAP). A few small studies have reported a positive correlation between renal phosphate losses, increased bone turnover and sAP. Methods: We analysed sAP dynamics in patients initiating (n=657), reinitiating (n=361) and discontinuing (n=73) combined antiretroviral therapy with and without TDF and assessed correlations with clinical and epidemiological parameters. Results: TDF use was associated with a significant increase of sAP from a median of 74 U/l (interquartile range 60–98) to a plateau of 99 U/l (82–123) after 6 months (P