Truvada PrEP Causes Only Minimal Bone Loss, Raltegravir Easier on Bones than PIs

Use of tenofovir/emtricitabine (Truvada) for HIV pre-exposure prophylaxis (PrEP) was associated with a small decrease in bone mineral density that stabilized after the first 6 months, according to study findings reported in the April 23 edition of Clinical Infectious Diseases. Related research showed that HIV-positive people starting an antiretroviral regimen containing the integrase inhibitor raltegravir (Isentress) experienced less bone loss than those taking protease inhibitors.

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ICAAC 2012: Atazanavir Linked to Kidney Stones in People with HIV

HIV positive people taking ritonavir-boosted atazanavir (Reyataz) are more likely to develop kidney stones than those using other antiretroviral medications, according to study data presented at the recent 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2012) in San Francisco and published in the November 1, 2012 issue of Clinical Infectious Diseases. Another study suggested that darunavir (Prezista) may also raise the risk.

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IDWeek 2014: Earlier Treatment, NNRTI Use Predict Slower HIV Rebound After Stopping ART

HIV viral load usually begins to rise again within 4 to 8 weeks after stopping antiretroviral therapy (ART), though starting treatment earlier in the course of infection and using a non-nucleoside reverse transcriptase inhibitor (NNRTI) may delay viral rebound, according to study findings presented at IDWeek 2014 last week in Philadelphia.

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NIH Offers Free Database of Drugs Associated with Liver Injury

The National Institutes of Health (NIH) last week launched the new LiverTox database of drugs known to have the potential to cause liver toxicity -- the leading cause of acute liver failure in the U.S. In addition to prescription drugs, it also includes over-the-counter medications, herbal remedies, and supplements. A number of antiretroviral drugs used to treat HIV appear on the list.

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IDWeek 2014: Longer Use, Age, Low Body Weight Raise Risk of Tenofovir Kidney Problems

Abnormal kidney biomarkers are common but rarely progress to serious kidney dysfunction in HIV positive people taking tenofovir, and longer duration of use, older age, and having diabetes or high blood pressure raise the risk, researchers reported at IDWeek 2014 last week in Philadelphia. A related study found that people with low body weight experienced progressive kidney function decline while taking tenofovir.

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CROI 2012: ART Liver Toxicity is Lower with Modern Regimens, but Still a Risk for HIV/HCV Coinfected

Liver toxicity related to antiretroviral therapy (ART) has become less common in recent years thanks to development of better tolerated drugs and improved understanding of how to use them. But HIV positive people coinfected with hepatitis C remain at higher risk, researchers reported at the 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012) this month in Seattle.

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HIV Positive Stimulant Users Benefit from Antiretroviral Therapy

People with HIV who use methamphetamine or other stimulant drugs do well on antiretroviral therapy (ART) and appear not to be at greater risk than non-users for AIDS-related or all-cause death overall, but those who use stimulants more than half the time did have a higher risk of progression to AIDS or death, according to a study published in the September 30 Journal of Acquired Immune Deficiency Syndromes.

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UCSF Answers Patient and Provider Questions about Tenofovir Kidney Study

The University of California at San Francisco (UCSF) has issued a set of frequently asked question and answers for patients and clinicians regarding a study in this week's issue of AIDS finding a link between tenofovir (Viread, also in the Truvada and Atripla combination pills) and kidney impairment.

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ICAAC 2013: Researchers Present Data on New NNRTIs AIC292 and MK-1439

A pair of next-generation HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs) demonstrated promising activity in early studies, researchers reported last week at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2013) in Denver. AIC292 showed good antiviral activity in early laboratory, animal and human studies. MK-1439, now in Phase 2b, is likely to interact with ritonavir, but not tenofovir.

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Large Study Finds Tenofovir Linked to Increased Kidney Risk

HIV positive people who took tenofovir (Viread, also in the Truvada and Atripla combination pills) were more likely to show signs of impaired kidney function, according to an observational study of more than 10,000 people described in the February 4, 2012, advance online edition of AIDS.

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ICAAC 2013: Dolutegravir Shows Good Efficacy Across Patient Groups

The new integrase inhibitor dolutegravir (Tivicay) worked better than boosted darunavir for people starting HIV treatment for the first time, researchers reported at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2013) last week in Denver. Another study found that dolutegravir worked well across sex, race/ethnicity, and age groups.

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IDSA 2011: Tenofovir Not Linked to Increased Kidney Risk in HIV+ Veterans Study

Use of tenofovir (Viread, also in the Truvada and Atripla coformulations) was not associated with a higher risk of kidney toxicity compared with other antiretroviral agents, according to a study presented at the 49th Annual Meeting of the Infectious Diseases Society of America (IDSA 2011) last month in Boston.

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ICAAC 2013: New Tenofovir Formulation Has Less Effect on Kidneys and Bones

Tenofovir alafenamide (TAF), a new formulation that reaches higher levels in cells but allows for lower dosing, was as effective as the current tenofovir disoproxil fumarate (TDF) formulation but had less impact on markers of kidney function and bone turnover, researchers reported at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2013) this week in Denver.

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ICAAC 2011: Cobicistat Matches Ritonavir as Booster, Studies Clarify Effects on Kidney Function

The experimental pharmacoenhancing agent cobicistat continues to work as well as ritonavir for boosting other antiretroviral drugs, according to findings published in the September 24, 2011, issue of AIDS.

In addition, 2 studies presented this week at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2011) shed further light on cobicistat's impact on the kidneys, indicating that it reduces estimated but not actual glomerular filtration rate (GFR) by altering activity in the proximal renal tubules.

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IAS 2013: Kidney Problems Linked to Tenofovir Use, Improve with Switch to Abacavir

Indian people with HIV who took tenofovir had a higher rate of kidney impairment than westerners, according to a study presented at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) this month in Kuala Lumpur. A related study found that switching from tenofovir to abacavir reduced kidney risk.

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Meta-analysis Finds Tenofovir Linked to Modest Kidney Impairment, No Increase in Bone Fractures

Use of tenofovir (Viread, also in the Truvada and Atripla combination pills) was found to be associated with statistically significant loss of kidney function in a systematic review and meta-analysis, but this was considered to have only a modest clinical impact, researchers reported in the September 15, 2010 issue of Clinical Infectious Diseases. This review also found no link between tenofovir and bone fractures. Researchers concluded that tenofovir use does not need to be limited in areas where kidney function cannot be adequately monitored.