Evidence map›Paper›PMID 39039812›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025

Effect of 2 Forms of Tenofovir on Duodenal Enterocytes-A Hypothesis for Different Effect of Tenofovir Disoproxil Fumarate and Tenofovir Alafenamide on Body Weight and Plasma Lipids.

Kai Juhani Kauppinen, Inka Aho, Nelli Sjöblom, Olli Tynninen, Anu Suomalainen, Ursula Schwab, Fang Zhao, Perttu Arkkila, Jussi Sutinen

Registry-linked trialAbstract readClinical Trial, Phase IV
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05326971 (The Effect of Tenofovir Disoproxil Fumarate), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05326971 phase4unknown statusnot on this map

The Effect of Tenofovir Disoproxil Fumarate (TDF) Versus Tenofovir Alafenamide (TAF) on Proximal Small Intestine - a Potential Mechanism to Explain Opposing Effects on Body Weight

TypeinterventionalSponsorJussi SutinenRan2023 to 2025Enrolled24ConditionsHIV Infections, Weight GainArmsgastroscopy
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Tenofovir, Interferon Pathways, and Mucosal Immunity: Implications for People Living With HIV.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kai Juhani KauppinenDepartment of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-9683-8152
Inka AhoDepartment of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.
Nelli SjöblomFaculty of Medicine, University of Helsinki, Helksinki, Finland.
Olli TynninenFaculty of Medicine, University of Helsinki, Helksinki, Finland.
Anu SuomalainenStem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Ursula SchwabSchool of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0003-1838-7525
Fang ZhaoFaculty of Medicine, University of Helsinki, Helksinki, Finland.
Perttu ArkkilaFaculty of Medicine, University of Helsinki, Helksinki, Finland.
Jussi SutinenDepartment of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.

Funding

the Emil Aaltonen Foundationthe Finnish Medical Foundationthe Finnish Subsidy for Health Science Researchthe Infectious Diseases Society in Finlandthe Maud Kuistila Memorial Foundation
6 · The paper itself

Abstract

backgroundTenofovir disoproxil fumarate (TDF), compared to tenofovir alafenamide (TAF), leads to lower body weight and plasma lipids by an unknown mechanism. We hypothesize that TDF, when absorbed, may damage enterocytes of the proximal duodenum, leading to reduced absorption of nutrients.

methodsPeople with human immunodeficiency virus, without significant gastrointestinal symptoms, receiving a regimen containing TDF (n = 12) or TAF (n = 12), underwent esophagogastroduodenoscopies. Plasma/serum concentrations of nutrients absorbed from proximal duodenum and serum intestinal fatty acid-binding protein (I-FABP), a marker of enterocyte damage, were measured. Cytochrome c oxidase/succinate dehydrogenase (COX/SDH) staining and electron microscopy (EM) were conducted to evaluate mitochondria.

resultsFive patients in the TDF group (1 celiac disease [excluded from further analyses], 1 Helicobacter gastritis, and 3 esophagitis) and 2 in the TAF group (2 esophagitis) had a pathological finding in esophagogastroduodenoscopy. Villi were flatter (337 [59] vs 397 [42] μm; P = .016), crypts nonsignificantly deeper (200 [46] vs 176 [27] μm; P = .2), and villus-to-crypt ratio lower (1.5 [0.42] vs 2.5 [0.51]; P = .009) in the TDF versus TAF group (mean [standard deviation]). I-FABP concentration was higher in the TDF versus TAF group (3.0 [1.07] vs 1.8 [0.53] ng/mL; P = .003). The TDF group had numerically but not statistically significantly lower concentrations of folate and vitamins A, B1, D, and E. COX/SDH staining and EM showed similar mitochondrial damage in both groups.

conclusionsDuodenal villous alterations may explain TDF-associated decrease in body weight and plasma lipids. Larger studies are needed to evaluate concentrations of nutrients absorbed from duodenum among TDF users.. CLINICAL TRIALS REGISTRATION: NCT05326971; EudraCT 2022-000849.

Indexed as

AdenineAnti-HIV AgentsBody WeightDuodenumEnterocytesHIV InfectionsLipidsTenofovirAdultAlanineFemaleHumansMaleMiddle AgedAdenineAlanineAnti-HIV AgentsLipidsTenofovirtenofovir alafenamideduodenal villusenterocyteintestinal fatty acid–binding proteintenofovir alafenamidetenofovir disoproxil fumarate

Identifiers

PMID39039812
PMCPMC11848257

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.