damage, like all other recently reported cases, occurred in patients receiving the protease inhibitor
, often with lopinavir. Increased plasma concentrations
of didanosine were also observed after the addition of tenofovir. It was suspected that tenofovir with PIs interacted with renal organic anion transporters
, leading to nephrotoxic tubular concentrations
of tenofovir and systemic
accumulation of didanosine. Until there is a better understanding of these interactions, close monitoring is recommended for patients receiving tenofovir, PIs, and didanosine.