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Liatsou E, Tatouli I, Mpozikas A, Pavlou MM, Gakiopoulou H, Ntanasis-Stathopoulos I, Gavriatopoulou M, Kontogiannis S, Dimopoulos MA. Tenofovir-Induced Fanconi Syndrome Presenting with Life-Threatening Hypokalemia: Review of the Literature and Recommendations for Early Detection. J Clin Med 2023; 12:7178. [PMID: 38002790 PMCID: PMC10672342 DOI: 10.3390/jcm12227178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
Tenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor that has been widely used for the treatment of patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infections. Despite the excellent safety records of this regimen, a few cases of acute renal failure and Fanconi syndrome have been reported among HIV patients exposed to TDF. However, in the HBV monoinfection scenario, only five cases of TDF-associated Fanconi syndrome have been reported thus far, two of them providing a confirmatory kidney biopsy. Here, we describe the case of a 68-year-old woman with chronic hepatitis B (CHB) who developed TDF-induced Fanconi syndrome that reverted after TDF withdrawal from tenofovir alafenamide. Though the overall risk of TDF-associated severe renal toxicity in HBV patients appears to be negligible, both glomerular and tubular functions should be monitored in patients exposed to TDF.
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Affiliation(s)
- Efstathia Liatsou
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
| | - Ioanna Tatouli
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
| | - Andreas Mpozikas
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
| | - Maria-Markella Pavlou
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
| | - Hariklia Gakiopoulou
- 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
| | - Sofoklis Kontogiannis
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
| | - Meletios Athanasios Dimopoulos
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.L.); (I.T.); (A.M.); (M.-M.P.); (M.G.); (S.K.)
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