To the Editor: Tenofovir disoproxil fumarate is a nucleotide analogue reverse transcriptase inhibitor that is used in Australia as first-line antiviral treatment for HIV infection.1,2 Tenofovir may be nephrotoxic, particularly affecting proximal tubular function.3 We report a case of tenofovir-associated Fanconi syndrome, which demonstrates the need for vigilance in patients taking tenofovir.
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- 1. Gallant JE, DeJesus E, Arribas JR, et al. Tenofovir DF, emtricitabine, and efavirenz vs zidovudine, lamivudine and efavirenz for HIV. N Engl J Med 2006; 354: 251-260.
- 2. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of anti-retroviral agents in HIV-1-infected adults and adolescents, with Australian commentary. http://www.ashm.org.au/projects/arvguidelines (accessed Jan 2012).
- 3. Hall AM, Hendry BM, Nitsch D, et al. Tenofovir-associated kidney toxicity in HIV-infected patients: a review of the evidence. Am J Kidney Dis 2011; 57: 773-780.
- 4. Gupta SK, Eustace JA, Winton JA, et al. Guidelines for the management of chronic kidney disease in HIV-infected patients: recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 2005; 40: 1559.
- 5. European AIDS Clinical Society. Guidelines: clinical management and treatment of HIV infected adults in Europe. http://www.europeanaidsclinical society.org/images/stories/EACS-Pdf/eacs guidelines-v6_english.pdf (accessed Jan 2012).
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