Persistently elevated alkaline phosphatase could be related to Paget's disease of bone in a patient receiving tenofovir disoproxil fumarate.

The prevalence of Paget's disease of bone (PDB) reaches 1-2% of all adults aged ≥55 years old. However, reports describing PDB among HIV positive patients are extremely rare. We report here the case of a HIV positive person receiving tenofovir disoproxil fumarate (DF)-based antiretroviral therapy and who had persistently elevated alkaline phosphatase (AP) revealing PDB.