Impact of antiretroviral treatment containing tenofovir difumarate on the telomere length of aviremic HIV-infected patients

OBJECTIVE:To evaluate the in vivo relevance of the inhibitory effect of tenofovir upon telomerase activity observed in vitro. DESIGN:Cross sectional study of HIV-infected patients with suppressed virological replication (HIV RNA < 50 copies/mL for more than one year) MethodsTelomere length in whole blood was measured by quantitative real time PCR. We performed a multivariate analysis to elucidate variables associated with telomere length and also evaluated the association between telomere length and use of tenofovir difumarate (TDF) adjusted by significant confounders RESULTS:200 patients included, 72% male, median age 49 (IQR 45-54.5), 103 with exposure to a TDF containing ART regimen (69.9% for more than 5 years) and 97 never exposed to a TDF containing ART regimen. In the multivariate analysis significant predictors of shorter telomere length were older age (p = 0.008), parental age at birth (p = 0.038), Caucasian race (p = 0.048) and longer time of known HIV infection (10-20 years and ≥20 years compared with