Tenofovir Use Is Not Associated with Reduced Bone Density or Fractures in Liver Transplant Recipients.
N. Lim, C. Engler, J. Lake.
University of Minnesota, Minneapolis, MN
Meeting: 2017 American Transplant Congress
Abstract number: B200
Keywords: Bone, Liver transplantation, Osteoporosis, Viral therapy
Session Information
Session Name: Poster Session B: Liver Retransplantation and Other Complications
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background
Tenofovir disproxil fumarate (TDF) and reduced bone density in the HIV population is well-documented. The effect of TDF use on bone density in patients who undergo liver transplantation is unknown.
Methods
A single-center, retrospective review of all patients who underwent liver transplant from 2002 to 2016. Patients receiving TDF were compared with patients who had never received TDF to evaluate for reduced bone mineral density and fractures after transplant. Reduced bone mineral density was defined as osteopenia or osteoporosis based on DEXA scan reports. Multivariate analysis was then performed for these two outcomes. Secondary analysis was performed comparing patients receiving TDF with controls with viral hepatitis. Viral hepatitis controls were defined as patients with chronic hepatitis C or B in the absence of TDF use.
Results
995 patients received liver transplants from 2002 to 2016. 343 patients were female (34.5%). 79 (7.9%) patients were transplanted with chronic hepatitis B. 11/57 (19.3%) patients on TDF developed reduced bone mineral density compared with 163/938 (17.4%) patients who had never received TDF (p=0.71). 6/57 (10.5%) patients on TDF developed fractures compared with 170/938 (18.1%) patients in the non-TDF group (p=0.14). TDF use was not associated with reduced bone mineral density (OR, 1.47; 95% CI 0.73-2.95, p=0.28) or fractures (OR, 0.815; 95% CI 0.34-1.98, p= 0.65).
There were 345 controls with viral hepatitis. 53/345 (13.18%) viral hepatitis controls developed reduced bone mineral density (p=0.45, compared to TDF) and 60/345 (14.93%) developed fractures (p=0.19). TDF use was not associated with reduced bone mineral density (OR 1.382; 95% CI 0.67-2.85, p=0.38) or fractures (OR 1.02; 95% CI 0.39-2.66, p=0.97) compared to viral hepatitis controls.
Conclusion
TDF use is not associated with reduced bone density or fractures after liver transplant. Specialized screening strategies for osteopenia or osteoporosis are not warranted for liver transplant patients on TDF.
CITATION INFORMATION: Lim N, Engler C, Lake J. Tenofovir Use Is Not Associated with Reduced Bone Density or Fractures in Liver Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lim N, Engler C, Lake J. Tenofovir Use Is Not Associated with Reduced Bone Density or Fractures in Liver Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/tenofovir-use-is-not-associated-with-reduced-bone-density-or-fractures-in-liver-transplant-recipients/. Accessed November 21, 2024.« Back to 2017 American Transplant Congress