Mothobi Nomvuyo Z, Masters Jeffrey, Marriott Deborah J
Department of HIV, Immunology and Infectious Diseases; Department of Microbiology, St. Vincent's Hospital, NSW, Australia.
Department of HIV, Immunology and Infectious Diseases, St. Vincent's Hospital, Darlinghurst, NSW, Australia.
Ther Adv Infect Dis. 2018 Jul 10;5(5):91-95. doi: 10.1177/2049936118785497. eCollection 2018 Sep.
A case of tenofovir-induced Fanconi syndrome in a patient receiving antiretroviral therapy for HIV infection, with resolution of the related electrolyte abnormalities upon switch from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate, is reported. Tenofovir alafenamide fumarate, a novel prodrug of tenofovir containing significantly lower doses of tenofovir than tenofovir disoproxil fumarate, has been associated with a favourable renal profile compared to tenofovir disoproxil fumarate. Generally, the rare complication of tenofovir disoproxil fumarate-induced Fanconi syndrome is managed by cessation of tenofovir. There are limited reports of the impact of a switch strategy from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate, which may be necessary in patients unable to discontinue tenofovir.
报告了1例接受抗逆转录病毒治疗的HIV感染患者出现替诺福韦诱导的范科尼综合征，在从富马酸替诺福韦二吡呋酯转换为富马酸替诺福韦艾拉酚胺后，相关电解质异常得到缓解。富马酸替诺福韦艾拉酚胺是替诺福韦的一种新型前体药物，其替诺福韦剂量明显低于富马酸替诺福韦二吡呋酯，与富马酸替诺福韦二吡呋酯相比，具有良好的肾脏安全性。一般来说，富马酸替诺福韦二吡呋酯诱导的范科尼综合征这种罕见并发症通过停用替诺福韦来处理。关于从富马酸替诺福韦二吡呋酯转换为富马酸替诺福韦艾拉酚胺策略的影响的报告有限，而对于无法停用替诺福韦的患者，这种转换可能是必要的。
