Hepatitis B Virus Infection and the Kidney: Renal Abnormalities in HBV Patients, Antiviral Drugs Handling, and Specific Follow-Up

Abstract

Chronic hepatitis B virus (CHB) infection is one of the most common causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC) worldwide. Many patients with CHB have variable degrees of functional renal impairment, and approximately 2 to 15% of patients on hemodialysis have CHB. Several therapeutic regimens have been developed in the past years, among which oral nucleoside and nucleotide analogues have been demonstrated to be efficient and well tolerated. However, they all are excreted in the urine and may thus require dosage adjustment in patients with decreased renal function. Furthermore, a number of them may in addition be toxic to the kidneys, especially in those patients presenting with renal insufficiency.

Hepatitis B and renal function: A matched study comparing non‐hepatitis B, untreated, treated and cirrhotic hepatitis patients

“…Approximately, 240 million people are infected worldwide with chronic hepatitis B (CHB) with one million people dying annually from hepatitis B virus (HBV) . Therefore, CHB is considered one of the most common infectious diseases which can lead to complications such as cirrhosis, hepatic decompensation, hepatocellular carcinoma, and death as well is associated with extrahepatic manifestation to include renal impairment …”

“…[1][2][3] Therefore, CHB is considered one of the most common infectious diseases which can lead to complications such as cirrhosis, hepatic decompensation, hepatocellular carcinoma, and death as well is associated with extrahepatic manifestation to include renal impairment. 4,5 In fact, recent studies have found that chronic kidney disease (CKD) has increased in prevalence and incidence over the past years with the strongest predictors for CKD identified as hypertension, diabetes and cardiovascular disease. [6][7][8][9] However, treatment of CHB has also been implicated in the development of renal impairment to include the nucleoside analogs drugs of: lamivudine, entecavir (ETV) and telbivudine, or the nucleotide analogs adefovir dipivoxil and tenofovir disoproxil fumarate (TDF).…”

The detection of anti-dengue virus IgM in urine in participants enrolled in an acute febrile illness study in Puerto Rico

“…Currently most diagnostic laboratory tests for dengue require serum specimens to detect DENV nucleic acid during the acute phase of the illness (i.e., days post-illness onset [DPO] �5) or anti-DENV IgM during the convalescent phase (DPO [6][7][8][9][10][11][12][13][14]. A test that uses a noninvasive specimen such as urine could be of benefit in cases where serum is difficult to obtain (e.g., young children and elderly), and in fact, urine has been previously studied as a surrogate specimen for serum [4,5].…”

“…In most healthy individuals, IgM is not detected in the urine. However, in diseases in which there is transient acute or chronic kidney injury resulting in a change in glomerular capillary wall permeability, large proteins, including IgM, may be found in the urine [10][11][12]. In the case of dengue, acute kidney injury (AKI) and acute renal failure are potential medical complications associated with prolonged shock and/or rhabdomyolysis [13][14][15][16][17].…”

Telbivudine for the treatment of chronic hepatitis B in HBeAg-positive patients in China: a health economic analysis

“…Nucleos(t)ide analogs (NUCs) represent the mainstay of pharmacological treatment for CHB (Wong et al 2014 ). Five NUCs, namely telbivudine [LDT], entecavir [ETV], tenofovir [TDF], lamivudine [LAM], and adefovir dipivoxil [ADV], are currently being used for the treatment of CHB worldwide (Deray et al 2015 ). NUCs primarily act by suppressing HBV replication, thereby minimizing the risk of liver disease progression and subsequent complications, including hepatic decompensation and HCC, in both pre-cirrhotic and cirrhotic patients (Fung et al 2011 ).…”