Abstract
Tenofovir-related tubular damage, like all other recently reported cases, occurred in patients receiving the protease inhibitor (PI) ritonavir, often with lopinavir. Increased plasma concentrations of didanosine were also observed after the addition of tenofovir. It was suspected that tenofovir with PIs interacted with renal organic anion transporters, leading to nephrotoxic tubular concentrations of tenofovir and systemic accumulation of didanosine. Until there is a better understanding of these interactions, close monitoring is recommended for patients receiving tenofovir, PIs, and didanosine.
MeSH terms
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Acquired Immunodeficiency Syndrome / complications
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Acquired Immunodeficiency Syndrome / drug therapy*
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Adenine / analogs & derivatives*
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Adult
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Anti-HIV Agents / therapeutic use*
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Diabetes Insipidus, Nephrogenic / complications*
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Didanosine / therapeutic use
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Drug Therapy, Combination
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Fanconi Syndrome / chemically induced
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Fanconi Syndrome / complications*
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Humans
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Lopinavir
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Male
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Organophosphonates*
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Organophosphorus Compounds
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Pyrimidinones / therapeutic use
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Ritonavir / therapeutic use
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Tenofovir
Substances
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Anti-HIV Agents
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Organophosphonates
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Organophosphorus Compounds
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Pyrimidinones
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Lopinavir
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Tenofovir
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Adenine
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Didanosine
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Ritonavir