Abstract:
Background: While TenofovirDisoproxil Fumarate
(TDF) has achieved great success in the treatment
of HIV infection, there have been reports of TDFinduced
Fanconi syndrome. TDF is a key component
of first line antiretroviral regimens with increasing
use, particularly in developing countries. Whereas,
much attention has been focused on other renal
complications of TDF, very little has been studied in
Nigeria to address the potential proximal renal tubular
dysfunction with its attendant complications, such as
osteomalacia.
Case Report: We describe the case of a 52
year old HIV infected Nigerian woman on TDF
plusEmtricitabine plus ritonavir-boosted
LopinavirAntiretroviral Therapy (ART) who
presented with osteomalacia and micro fractures due
to renal phosphate wasting which resolved following
discontinuation of TDF and supplementation with
Calcium (Calcium Sandoz 1000mg OD), Vitamin D
(Cholecalciferol 1000mg BID and alfacalcidol 0.5mg
OD) and Phosphate (Potassium phosphate
monobasic, sodium phosphate dibasic dihydrate 1
BID).
Conclusion: This case highlights the
importance of considering the diagnosis of
osteomalacia among HIV infected Nigerians on TDF
containing ART. We recommend regular monitoring
of renal tubular function, bone alkaline phosphatase
