Infants exposed to the HIV drug tenofovir disoproxil fumarate in the womb may have lower bone mineral content than those exposed to other drugs used to treat HIV, according to an NIH-sponsored study published in Clinical Infectious Diseases.

The study included a total of 143 infants, 74 of whom were exposed to tenofovir in utero and 69 of whom were given other anti-HIV drugs. Dual X-ray absorptiometry (DXA) scans were used to measure bone mineral content within the first 4 weeks of birth.

Results indicated that pregnant women exposed to tenofovir in their third trimester gave birth to babies whose bone mineral content was 12% lower than that of infants not exposed to tenofovir in utero.

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While the authors say the study results are concerning, they caution against making therapy changes. Tenofovir has proven successful in treating HIV in pregnant women and is often used to prevent HIV transmission to infants. It is also unknown whether the lower bone mineral content is abnormal and will increase the risk for fractures or whether these children with regain bone mineral content as they get older.

“At this point, we can say that those who care for pregnant women with HIV and their children should be aware that prescribing tenofovir to pregnant women could be a concern for their infants’ bones,” George K. Siberry, MD, first author of the study and medical officer with the NIH’s Eunice Kennedy Shriver National Insitute of Child Health and Human Development (NICHD), said in a press release.

“Families should keep in close touch with their physicians to monitor their child’s bone development.”

Additional studies will need to be conducted to better understand how the drug affects bone health in children born to mothers exposed to tenofovir during pregnancy.


  1. Siberry GK, Jacobsen DL, Kalkwarf HJ, et al; Pediatric HIV/AIDS Cohort Study. Lower Newborn Bone Mineral Content Associated With Maternal Use of Tenofovir Disoproxil Fumarate During Pregnancy. Clin Infect Dis. 2015;61(6):996-1003.

This article originally appeared on MPR