Associations Between Tenofovir Diphosphate in Dried Blood Spots, Impaired Physical Function, and Fracture Risk. (27th November 2020)

• Record Type: Journal Article
• Authors: Abdo, Mona; Coyle, Ryan P; Seifert, Sharon M; Castillo-Mancilla, Jose R; Jankowski, Catherine M; Mawhinney, Samantha; Anderson, Peter L; Erlandson, Kristine M
• Is Part Of: Open forum infectious diseases. Volume 8:Number 1(2021)
• Publication Date: 2020-11-27
• Subjects: aging -- bone mineral density -- dried blood spots -- HIV -- tenofovir diphosphate; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofaa577
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: In this study, we evaluate associations between cumulative antiretroviral adherence/exposure, quantified using tenofovir diphosphate (TFV-DP) in dried blood spots (DBS), and human immunodeficiency virus (HIV)-related aging factors. Methods: This is a cross-sectional analysis of younger (ages 18–35) and older (ages ≥60) persons with HIV (PWH) taking TFV disoproxil fumarate. Tenofovir diphosphate concentrations were quantified in DBS. Linear and logistic regression models were used to evaluate associations between TFV-DP and bone mineral density (BMD), physical function, frailty, and falls. Results: Forty-five PWH were enrolled (23 younger, 22 older). Every 500 fmol/punch (equivalent to an increase in ~2 doses/week) increase in TFV-DP was associated with decreased hip BMD (−0.021 g/cm 2 ; 95% confidence interval [CI], −0.040 to −0.002; P = .03). Adjusting for total fat mass, every 500 fmol/punch increase in TFV-DP was associated with higher odds of Short Physical Performance Battery impairment (score ≤10; adjusted odds ratio [OR], 1.6; 95% CI, 1.0–2.5; P = .04). Every 500 fmol/punch increase in TFV-DP was associated with slower 400-meter walk time (14.8 seconds; 95% CI, 3.8–25.8; P = .01) and remained significant after adjusting for age, lean body mass, body mass index (BMI), and fat mass (all P ≤ .01). Every 500 fmol/punch increase in TFV-DP was associated with higher odds of reporting a fall in the prior 6 months (OR, 1.8; 95% CI, 1.1–2.8; P = .02); this remained significant after adjusting for age, lean body mass, BMI, and total fat mass (all P < .05). Conclusions: Higher TFV-DP levels were associated with lower hip BMD, poorer physical function, and greater risk for falls, a concerning combination for increased fracture risk. Abstract : The associations between tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) and human immunodeficiency virus (HIV)-related aging factors was evaluated. Higher TFV-DP levels were found to be associated with impaired physical function and fracture risk.