Long-Term Use of TDF Leads to Bone Disease in HIV Patients

Case Overview

This case involves multiple plaintiffs who have undergone a medication regimen for HIV therapy, specifically including tenofovir disoproxil fumarate (TDF). Over the years, the administration of TDF and other antiviral medications has allegedly induced bone toxicity resulting in osteoporosis, osteopenia, and bone demineralization, ultimately leading to fractures. The plaintiffs seek an expert in endocrinology to opine on the causation of whether TDF contributed to the abnormalities in bone metabolism observed in these individuals.

Questions to the Endocrinology expert and their responses

How often do you evaluate and manage patients with abnormalities in bone metabolism?

I have over 20 years of experience as an endocrinologist. I evaluate and manage patients with abnormalities in bone metabolism a couple of times per week in my practice.

How might long-term administration of TDF contribute to the development of bone disease including osteoporosis, osteopenia, or demineralization?

Long-term administration of TDF contributes to the development of bone disease under several basic mechanisms, including sympathetic effects, lipocalin, and osteocalcin effects as well as other mechanisms. It is clinically well-established that antiretrovirals do cause bone loss.

About the expert

This expert has over 20 years of experience in the field of endocrinology. He earned his MD and his PhD from Ludwig Maximilians University, where he also completed his first internship and residency. He then completed an additional internship and residency at Bellevue Hospital and New York Harbor Health Care System, followed by an endocrine research fellowship at Harvard Medical School and a clinical endocrine fellowship at Albert Einstein College and Montefiore Hospital. Today, this expert is board certified in endocrinology, metabolism, and diabetes. He also stays active in his field as a member of many professional societies, including the Endocrine Society, the American Diabetes Association, and the American Society of Clinical Investigation. Currently, he serves as a medical attending at a top-ranked hospital as well as a professor at a top-ranked medical school, both in New York. He is also a professor, the chief of endocrinology, metabolism, and nutrition, and the vice chair of basic research at a university in New Jersey.

E-995583

Specialties:

Endocrinology