Tenofovir Disoproxil Fumarate-Associated Fanconi Syndrome in an Human Immunodeficiency Virus (HIV)-Uninfected Man Receiving HIV Pre-Exposure Prophylaxis

Tenofovir disoproxil fumarate (TDF) has been used worldwide in antiretroviral regimens of human immunodeficiency virus (HIV)-infected patients since being approved by the US Food and Drug Administration in 2001. Tenofovir disoproxil fumarate can cause renal tubular dysfunction and reduced renal function [1]. In its fully developed form, TDF renal dysfunction is associated with hypophosphatemia, renal phosphate wasting, and other features of Fanconi syndrome [1]. Cases of TDF-associated Fanconi syndrome have been reported predominantly among patients with HIV infection [1]. There has been no excess risk of renal tubular toxicity with TDF-emtricitabine (TDF-FTC) detected in large, placebo-controlled trials of HIV pre-exposure prophylaxis (PrEP) [2, 3]. One other well documented likely Fanconi syndrome has been reported in an online supplement to the latter paper [3]. In this study, we report an additional case of this previously described phenomenon.