Tenofovir Alafenamide Fumarate Induced Hypoglycemia in HIV Positive Patient with Insulin Dependent Diabetes

With the advances in highly active antiretroviral therapy, HIV is now considered a chronic disease. However, as the HIV population ages and have more co-morbidities, clinicians need to be increasingly aware about medication interactions. From our literature search, this is the first known case report of a patient switched from tenofovir disoproxil to tenofovir alafenamide and experienced improved renal proximal tubular function which we hypothesize led to improved insulin reuptake resulting in hypoglycemic episodes and subsequent need for insulin dose adjusting.