Recovery of Bone Mineral Density After Discontinuation of Tenofovir-Based HIV Pre-exposure Prophylaxis

dc.creatorGlidden, David V.
dc.creatorMulligan, Kathleen
dc.creatorMcMahan, Vanessa
dc.creatorAnderson, Peter L.
dc.creatorGuanira, Juan
dc.creatorChariyalertsak, Suwat
dc.creatorBuchbinder, Susan P.
dc.creatorBekker, Linda Gail
dc.creatorSchechter, Mauro
dc.creatorGrinsztejn, Beatriz
dc.creatorGrant, Robert M.
dc.date2018-04-09T16:01:16Z
dc.date2018-04-09T16:01:16Z
dc.date2017
dc.date.accessioned2023-09-26T22:13:52Z
dc.date.available2023-09-26T22:13:52Z
dc.identifierGLIDDEN, David V. et al. Recovery of Bone Mineral Density Following Discontinuation of Tenofovir-Based HIV Pre-Exposure Prophylaxis. Journal of Acquired Immune Deficiency Syndromes, v. 76, n. 2, p. 1-17, Oct. 2017.
dc.identifier0894-9255
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/25686
dc.identifier10.1097/QAI.0000000000001475
dc.identifier10.1097/QAI.0000000000001475
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8876565
dc.descriptionBackground: Oral tenofovir disoproxil fumarate (TDF) for HIV prevention and treatment is associated with decreases in bone mineral density (BMD). Previous reports suggest that these changes may be reversible after discontinuation of TDF. Setting: A metabolic substudy of 498 participants in a randomized, placebo-controlled HIV prevention trial of oral co-formulated TDF with emtricitabine (TDF/FTC, Truvada®) for HIV preexposure prophylaxis (PrEP) enrolling a global sample of men who have sex with men and trans women. Methods: Participants underwent dual X-ray absorptiometry (DXA) to quantify bone mineral density (BMD) in the hip and spine during PrEP and at 2 visits after stopping (median of 23 and 79 weeks postPrEP, respectively). Results are stratified by pharmacologic measure of TDF/FTC adherence. Results: There was no significant difference in change in hip/spine BMD at any timepoint between placebo and those with low adherence. Adherent participants had a mean (standard error) BMD change at TDF/FTC discontinuation of -1.02% (0.24) in the hip and -1.84% (0.36) in the spine. After stop, annualized BMD increases of 1.13% per year (0.27) in hip and 1.81% per year (0.36) in spineBMD were observed in adherent participants compared with 0.19% (0.16) and 0.74% (0.21) in the placebo group, respectively (p=0.003, both comparisons). On average, BMD returned to baseline levels by 1 year after PrEP stop. Recovery was consistent across age, baseline BMD z-score and treatment duration.
dc.description2018-10-31
dc.formatapplication/pdf
dc.languageeng
dc.rightsopen access
dc.subjectPre-Exposure Prophylaxis
dc.subjectTenofovir
dc.subjectEmtricitabine
dc.subjectBone Density
dc.subjectAbsorptiometry, Photon
dc.subjectProfilaxia Pré-Exposição
dc.subjectTenofovir
dc.subjectEmtricitabina
dc.subjectDensidade Óssea
dc.subjectAbsorciometria de Fóton
dc.titleRecovery of Bone Mineral Density After Discontinuation of Tenofovir-Based HIV Pre-exposure Prophylaxis
dc.typePreprint


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