Background: Tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity is related to high plasma tenofovir concentrations. Tenofovir alafenamide (TAF) is a tenofovir prodrug with 90% lower plasma tenofovir concentrations. The aim of this study was to evaluate changes in tenofovir-induced nephrotoxicity in Human Immunodeficiency Virus (HIV)-positive patients who switched from TDF to TAF. Materials and Methods: We identified all HIV-positive patients who switched from elvitegravir/cobicistat/emtricitabine/TDF to elvitegravir/cobicistat/emtricitabine/TAF at a tertiary hospital. We assessed tubulopathy and renal dysfunction before TDF administration, at the time TAF was used following at least 3 months of TDF use, and 3 months after TAF administration. Tubulopathy was defined by the presence of at least three abnormalities in fractional excretion of phosphate, fractional excretion of uric acid, urinary β2-microglobulin, urinary N-acetyl-β-D-glucosaminidase, glucosuria or proteinuria. Renal dysfunction was defined as decreased by more than 25% in the estimated glomerular filtration rate (eGFR) relative to baseline. Results: In 80 patients, the mean eGFR was 96.8 mL/min/1.73 m 2 before administration of TDF, 81.2 (P <0.001) at the time of change to TAF, 90.9 (P <0.001) after TAF administration.Renal dysfunction occurred in 19 patients (23.8%) after TDF use for a median 15 months, 11 (57.9%) of these patients recovered from renal dysfunction after TAF administration.Six patients (7.5%) had tubulopathy before TDF administration, 36 (45.0%) after TDF administration (P <0.001), 12 (15.0%) after TAF administration (P = 0.002). Conclusion Tenofovir-induced nephrotoxicity in HIV-positive patients receiving TDF was mostly reversible after changing to TAF. Thus, TAF-containing regimens can be administered safely to HIV-positive patients with tenofovir-induced nephrotoxicity.

OBJECTIVE: To investigate whether the dual route model is applicable to Korean word reading in acquired dyslexia after stroke. METHOD: Sixty-two year old patient with dyslexia after left inferior temporal and occipital lobe infarct was evaluated according to the lexical processing. After evaluation of general cognitive and language function, visual perception, semantic, and lexical stages were assessed. RESULTS: Visual perception was appropriate, and semantic categorization and picture-word matching tasks were 80.6% and 78.6% correct, respectively. Lexical decision task showed no significant differences within word classes, except shorter reaction time in reading words of Korean origin than those of chinese origin (p <0.05). The patient was able to read only 39.8% of tested words, and he could not read all the non-words. Reading of high frequency word was superior (65.4%) to that of low frequency words (10.9%) and semantic errors were not remarkable (p <0.05). CONCLUSION: The patient showed characteristics of recovery from deep to phonologic dyslexia with impairment of grapheme to phoneme conversion (GPC) route. These findings support that dual route model is applicable to Korean word reading.
Asian Continental Ancestry Group ; Dyslexia ; Dyslexia, Acquired ; Humans ; Language Disorders ; Occipital Lobe ; Reaction Time ; Semantics ; Stroke* ; Visual Perception