Division of Orthodontics.
Ther Clin Risk Manag. 2010 Feb 2;6:41-7.
Clinical observations have revealed a strong correlation between loss of bone density in HIV-infected individuals, particularly in conjunction with the antiretroviral drug tenofovir, a nucleotide analog that inhibits HIV reverse transcriptase. The most compelling correlations have been observed in clinical studies involving young children and adolescents. These observations strongly suggest that bone density is being affected during active bone growth and development, implicating a role for tenofovir in bone loss. Here we discuss the literature and potential mechanisms for how tenofovir-associated bone loss may arise, which likely involves perturbation of cellular DNA synthesis and gene expression. Elucidation of the mechanism(s) involved in tenofovir-mediated bone loss will help in developing adjuvant therapies to reduce tenofovir-associated bone density loss.
临床观察表明，HIV 感染者，特别是与抗逆转录病毒药物替诺福韦（一种抑制 HIV 逆转录酶的核苷酸类似物）同时使用时，会出现骨密度下降的强烈相关性。在涉及儿童和青少年的临床研究中观察到了最引人注目的相关性。这些观察结果强烈表明，骨密度在骨骼生长和发育的活跃时期受到影响，提示替诺福韦在骨丢失中起作用。在这里，我们讨论了文献和替诺福韦相关骨丢失可能出现的潜在机制，这可能涉及细胞 DNA 合成和基因表达的干扰。阐明替诺福韦介导的骨丢失的机制将有助于开发辅助治疗方法来减少替诺福韦相关的骨密度损失。
