Fanconi Syndrome Induced by Concomitant HIV PrEP and Tacrolimus

Fanconi syndrome (FS) is a severe grade of drug-induced proximal tubule toxicity. There are numerous causes for acquired FS, and drug toxicity is one of the most common. FS is known to be associated with the nucleoside reverse transcriptase inhibitor (NRTI) tenofovir disoproxil fumarate (TDF). TDF i...

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Bibliographic Details
Published in:JIM - high impact case reports 2021, Vol.9, p.23247096211050207-23247096211050207
Main Authors: Linn, Becky S., Vandiver, Jeremy W., Ren, Dylan, Shassetz, Joseph
Format: Article
Language:English
Subjects:
Antiretroviral drugs
Case Report
Case reports
HIV
Human immunodeficiency virus
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Summary:Fanconi syndrome (FS) is a severe grade of drug-induced proximal tubule toxicity. There are numerous causes for acquired FS, and drug toxicity is one of the most common. FS is known to be associated with the nucleoside reverse transcriptase inhibitor (NRTI) tenofovir disoproxil fumarate (TDF). TDF is often used in combination with emtricitabine (FTC) for preexposure prophylaxis (PrEP) of human immunodeficiency virus (HIV) infection. TDF/FTC-induced FS has been observed as a dose-related phenomenon that is directly correlated to kidney function, high levels of absorption of the drug into the proximal tubule, and interactions with other medications. This case report describes a patient who acquired FS after starting TDF/FTC for PrEP in the setting of chronic kidney disease (CKD) with concomitant tacrolimus therapy, a known nephrotoxic agent.
ISSN:2324-7096
2324-7096
DOI:10.1177/23247096211050207