Angelique Tjen-A-Looi, Shabnam N Naseer, Angus B Worthing, Joseph G Timpone and Princy N Kumar
We present three cases of HIV-infected patients who developed Fanconi syndrome, hypophosphatemic osteomalacia and bone fractures while on tenofovir, a nucleotide reverse transcriptase inhibitor, commonly used as part of HIV treatment. All patients presented with bone pain, electrolyte and radiographic abnormalities which improved with discontinuation of tenofovir. Although, there have been several studies demonstrating causality between tenofovir and Fanconi syndrome, there are only six previously reported cases of patients developing osteomalacia and fractures since the introduction of tenofovir in 2001. In addition to asymptomatic osteopenia, hypophosphatemic osteomalacia is an important, reversible adverse effect of tenofovir.
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