Changes in Renal Function in Patients With Chronic HBV Infection Treated With Tenofovir Disoproxil Fumarate vs Entecavir

Trinh, Sam; Le, An K.; Chang, Ellen T.; Hoang, Joseph; Jeong, Donghak; Chung, Marilyn; Lee, Hsuan-Shu; Wang, Uerica; Henry, Linda; Cheung, Ramsey; Nguyen, Mindie H.

doi:10.1016/j.cgh.2018.08.037

Cited by 42 publications

(61 citation statements)

References 27 publications

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“…Trinh et al . compared the effect of TDF and ETV on renal function and found that ETV treatment could recover the eGFR in patients with baseline eGFR <60 mL/min/1.73 m 2 . Similarly, in our study, as shown in Figure , patients with CKD stage G3–5 tended to improve their eGFR.…”

Section: Discussionsupporting

confidence: 79%

“…In contrast, in patients with renal dysfunction, the eGFR tended to restore (median eGFR, 48.8 and 56.0 mL/min/1.73 m 2 ; P = 0.184; Table ). In this study, the baseline age was older (baseline median age, 57 years) than those in previous reports; therefore, an age‐related decline in renal function might affect the renal function in patients with CKD stage 1 and 2 over the 5‐year observation period (Table ). However, although the median age was higher in patients with CKD 3/4 than in those with CKD stage G1/2, eGFR had the tendency to restore.…”

Section: Discussionmentioning

confidence: 73%

“…The observation period in the study by Trinh et al . was relatively long (median, 44 months); however, it only included a limited number of patients with moderate renal dysfunction ( n = 34), the efficacy of ETV in patients with renal dysfunction was not evaluated, and hemodialysis patients were not included in the study …”

Section: Discussionmentioning

confidence: 99%

“…In this study, baseline and changes in renal function was analyzed according to the estimated glomerular filtration rate (eGFR), in the same manner as in previous reports . The eGFR was calculated with the following equation: eGFR (mL/min/1.73 m 2 ) = 194 × serum creatinine −1.094 × age −0.287 × 0.739 (if female) .…”

Section: Methodsmentioning

confidence: 99%

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Entecavir treatment of hepatitis B virus‐infected patients with severe renal impairment and those on hemodialysis

Suzuki

Suda

Yamamoto

et al. 2019

Hepatology Research

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Aim Entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) are first‐line nucleos(t)ide analogues for hepatitis B virus (HBV)‐infected patients. However, consecutive TDF treatment causes renal dysfunction, and the safety and efficacy of TAF have not been established in severe renal dysfunction patients, including hemodialysis patients. The efficacy and safety of ETV in these populations has not been clarified. The study aimed to clarify this. Methods In this retrospective multicenter study, between 2006 and 2018, a total of 567 HBV‐infected patients treated with ETV monotherapy were screened. Patients were included if >20 years old, treated with ETV monotherapy for >1 year, and had proper clinical information. The efficacy of ETV and changes in renal function were evaluated according to renal function. Results A total of 273 patients were included: 9.2% (25/273), 1.8% (5/273), and 3.7% (10/273) had chronic kidney disease (CKD) stage G3, CKD stage G4/5, and were on hemodialysis, respectively. Overall, 84.2%, 94.0%, and 96.2% of patients experienced serum HBV‐DNA disappearance at 1, 2, and 3 years, respectively, after treatment initiation. In patients with CKD stage G3–5, estimated glomerular filtration rate tended to restore with time, which was in contrast to patients without renal dysfunction. The rate of disappearance in serum HBV‐DNA, alanine transaminase normalization, and virological breakthrough was similar between patients with or without renal dysfunction. ETV showed high efficacy for all 10 hemodialysis patients without virological breakthrough. Conclusions Entecavir for HBV‐infected patients with severe renal dysfunction, including hemodialysis patients, is highly effective and does not affect renal function.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Entecavir treatment of hepatitis B virus‐infected patients with severe renal impairment and those on hemodialysis

Suzuki

Suda

Yamamoto

et al. 2019

Hepatology Research

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“…These findings suggested that TDF does not need to be limited in patients with these characteristics. However, there are some studies that suggest hypertension or DM may be risk factors for renal insufficiency in patients with TDF use, and thus, further researches are necessary to confirm this. eGFR change from baseline was not different in patients with eGFR ≧60 mL/min/1.73 m 2 and < 60 mL/min/1.73 m 2 .…”

Section: Discussionmentioning

confidence: 98%

An observational study on long‐term renal outcome in patients with chronic hepatitis B treated with tenofovir disoproxil fumarate

Lim

Lee

Kim

et al. 2020

Journal of Viral Hepatitis

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In patients with chronic hepatitis B (CHB), long‐term effects of tenofovir disoproxil fumarate (TDF) on renal function have been controversial. This study aimed to analyse the real‐world long‐term effects of TDF on renal function in Korean patients with CHB. We analysed a cohort of 640 treatment‐naïve patients with CHB who were treated with TDF between May 2012 and December 2015 at Severance Hospital, Seoul, Republic of Korea. The mean age was 48.3 years old, and 59.5% were male. The proportions of hypertension and diabetes mellitus (DM) were 11.6% and 14.2%, respectively, and that of liver cirrhosis was 20.8%. During the 5‐year follow‐up, using a linear mixed model, serum creatinine increased from 0.77 ± 0.01 mg/dL to 0.85 ± 0.02 mg/dL (P < .001), and eGFR decreased from 102.6 ± 0.6 mL/min/1.73 m2 to 93.4 ± 1.4 mL/min/1.73 m2 (P < .001). In subgroup analysis, eGFR was statistically more decreased in patients with age > 60 than ≦60 years old (P = .027), and in patients with diuretic use than without diuretic use (P = .008). In multivariate analysis, the independent risk factors for eGFR decrease > 20% were baseline eGFR < 60mL/min/1.73 m2 (P = .034) and the use of diuretics (P < .001). CHB patients on TDF experienced greater reduction in renal function with age > 60 and with diuretic use compared to those without these characteristics. Baseline eGFR < 60 mL/min/1.73 m2 and use of diuretics were independent risk factors of eGFR decline of more than 20% on TDF therapy.

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Nonliver Comorbidities in Patients With Chronic Hepatitis B

Wei

Henry

Nguyen

2019

Clinical Liver Disease

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Changes in Renal Function in Patients With Chronic HBV Infection Treated With Tenofovir Disoproxil Fumarate vs Entecavir

Cited by 42 publications

References 27 publications

Entecavir treatment of hepatitis B virus‐infected patients with severe renal impairment and those on hemodialysis

Entecavir treatment of hepatitis B virus‐infected patients with severe renal impairment and those on hemodialysis

An observational study on long‐term renal outcome in patients with chronic hepatitis B treated with tenofovir disoproxil fumarate

Nonliver Comorbidities in Patients With Chronic Hepatitis B

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