Bone density, microarchitecture, and tissue quality after 1 year of treatment with tenofovir disoproxil fumarate

Robert Güerri-Fernández, Elisabet Lerma-Chippirraz, Ana Fernandez Marron, Natalia García-Giralt, Judit Villar-García, Jade Soldado-Folgado, Alicia González-Mena, Marta Trenchs-Rodríguez, Ana Guelar, Adolfo Díez-Pérez, Todd T. Brown, Hernando Knobel

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Objecive: Bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is used to assess bone health in HIV patients. DXA measures the amount of mineral, but not other key aspects of bone strength such as bone microarchitecture or bone quality. Trabecular bone score (TBS) and in-vivo microindentation directly measure trabecular microarchitecture and bone tissue quality, respectively. The aim of this study is to measure bone strength properties using these techniques. Results: Forty naive HIV patients who were going to start antiretroviral therapy (ART), a single pill treatment with elvitegravir/cobicistat, tenofovir disoproxil fumarate (TDF), emtricitavine (FTC) were included. A significant reduction in BMD at spine (-3.25%, P < 0.001) and in femoral neck (-3.82%, P = 0.016) between baseline and 48 weeks of treatment were found. Bone microarchitecture score at the spine, as measured by TBS, also significantly decreased from 1.357 (0.09) to 1.322 (0.09) (-2.5%, P = 0.011) between baseline to 48 weeks of treatment. Microindentation (BMSi) values were significantly higher than at baseline [89.04 (4.2) versus 86.07 (6.1); 3.49%, P < 0.001] after 48 weeks of TDF-based ART treatment, indicating improved bone material properties Conclusion: A significant decrease in BMD and TBS were observed after 1 year of TDF therapy. However, tissue quality significantly improved after 1 year of treatment, suggesting a recovery of bone material properties following the control of the infection despite the significant reduction of BMD. These techniques provide additional and necessary information to DXA about bone health in treated HIV patients, and because of its convenience and feasibility they could be routinely apply to assess bone in clinical practice.

Original languageEnglish (US)
Pages (from-to)913-920
Number of pages8
Issue number7
StatePublished - Apr 24 2018


  • HIV
  • bone quality
  • bone toxicity
  • tenofovir

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


Dive into the research topics of 'Bone density, microarchitecture, and tissue quality after 1 year of treatment with tenofovir disoproxil fumarate'. Together they form a unique fingerprint.

Cite this