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Previous studies among patients using tenofovir have shown a decline in bone-mineral content that is generally clinically irrelevant. However, given tenofovir’s potential effect on serum phosphorus levels and tubular function, investigators continue to examine whether long-term use of this compound affects bone metabolism. In this particular cohort study, researchers evaluated serum alkaline phosphatase (sAP) levels, assuming that they might correlate with bone turnover, among 330 patients initiating or restarting antiretroviral therapy with a tenofovir-based regimen and 688 doing so without a tenofovir-containing regimen.
The sAP values were similar between the groups at baseline but then increased significantly during tenofovir treatment —…