Associations Between Tenofovir Diphosphate in Dried Blood Spots, Impaired Physical Function, and Fracture Risk.

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/cm²; 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?ConclusionsHigher TFV-DP levels were associated with lower hip BMD, poorer physical function, and greater risk for falls, a concerning combination for increased fracture risk.

SUBMITTER: Abdo M 

PROVIDER: S-EPMC7781095 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature