Published in:
01-10-2012 | Original Article
Increase in serum mitochondrial creatine kinase levels induced by tenofovir administration
Authors:
Dai Watanabe, Munehiro Yoshino, Hiroki Yagura, Kazuyuki Hirota, Hitoshi Yonemoto, Hiroki Bando, Keishiro Yajima, Yusuke Koizumi, Hiroshi Otera, Shinjiro Tominari, Yasuharu Nishida, Takeshi Kuwahara, Tomoko Uehira, Takuma Shirasaka
Published in:
Journal of Infection and Chemotherapy
|
Issue 5/2012
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Abstract
Recently, 2 monoclonal antibodies that specifically inhibit mitochondrial creatine kinase (MtCK) activity have been developed. In this study, we measured the serum MtCK activity in HIV-1-infected individuals (n = 100) by employing a novel method using these antibodies. The mean serum MtCK activity in 44 patients treated with highly active antiretroviral therapy (HAART) including tenofovir disoproxil fumarate (TDF) was 16.0 IU/L. The MtCK activity was significantly higher in patients receiving TDF than in those receiving HAART without TDF (3.4 IU/L) or in naïve patients (6.9 IU/L) (Tukey–Kramer test, p < 0.0001 and p = 0.0029, respectively). The serum MtCK activity reached a plateau at 1 month after the initiation of TDF administration and decreased upon discontinuation. It showed no significant correlation with the trough plasma TDF concentration, serum creatinine level, or red blood cell count. The activity was elevated in 75% of the patients receiving TDF, and this elevation was specific to TDF; it was not observed with other anti-HIV drugs. In addition, our report emphasizes the careful interpretation of creatine kinase-MB (CK-MB) test results in patients receiving TDF because MtCK in serum could cause false-positive results on a conventional CK-MB test, which does not include MtCK-specific inhibitory antibodies.