Treatment Outcome and Renal Safety of 3-Year Tenofovir Disoproxil Fumarate Therapy in Chronic Hepatitis B Patients with Preserved Glomerular Filtration Rate

被引:14
作者
Min, In Suk [1 ]
Lee, Chang Hun [1 ]
Shin, Ik Sang [1 ]
Lee, Na Eun [1 ]
Son, Hong Seon [1 ]
Kim, Seung Bum [1 ]
Seo, Seung Young [1 ]
Kim, Seong Hun [1 ]
Kim, Sang Wook [1 ]
Lee, Seung Ok [1 ]
Lee, Soo Teik [1 ]
Kim, In Hee [1 ]
机构
[1] Chonbuk Natl Univ, Chonbuk Natl Univ Hosp, Dept Internal Med, Biomed Res Inst,Res Inst Clin Med,Med Sch, 20 Geonji Ro, Jeonju 54907, South Korea
关键词
Antiviral agents; Hepatitis B; chronic; Tenofovir; Treatment outcome; Renal insufficiency; LONG-TERM SAFETY; COMBINATION THERAPY; ANALOG THERAPY; RESCUE THERAPY; EFFICACY; ADEFOVIR; RESISTANCE; ENTECAVIR; EMTRICITABINE; NUCLEOSIDE;
D O I
10.5009/gnl18183
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: To investigate the treatment efficacy and renal safety of long-term tenofovir disoproxil fumarate (TDF) therapy in chronic hepatitis B (CHB) patients with preserved renal function. Methods: The medical records of 919 CHB patients who were treated with TDF therapy were reviewed. All patients had preserved renal function with an estimated glomerular filtration rate (eGFR) of at least 60 mL/min/1.73 m(2). Results: A total of 426 patients (184 treatment-naive and 242 treatment-experienced) were included for analysis. A virologic response (VR) was defined as achieving an undetectable serum hepatitis B virus (HBV) DNA level, and the overall VR was 74.9%, 86.7%, and 89.4% at the 1, 2, and 3-year follow-ups, respectively. Achieving a VR was not influenced by previous treatment experience, TDF combination therapy, or antiviral resistance. In a multivariate analysis, being hepatitis B e antigen positive at baseline and having a serum HBV DNA level >= 2,000 IU/mL at 12 months were associated with lower VR rates during the long-term TDF therapy. The overall renal impairment was 2.9%, 1.8%, and 1.7% at the 1, 2, and 3-year follow-ups, respectively. With regard to renal safety, underlying diabetes mellitus (DM) and an initial eGFR of 60 to 89 mL/min/1.73 m(2) were significant independent predictors of renal impairment. Conclusions: TDF therapy appears to be an effective treatment option for CHB patients with a preserved GFR. However, patients with underlying DM and initial mild renal dysfunction (eGFR, 60 to 89 mL/min/1.73 m(2)) have an increased risk of renal impairment.
引用
收藏
页码:93 / 103
页数:11
相关论文
共 44 条
  • [1] Treatment Efficacy and Safety of Tenofovir-Based Therapy in Chronic Hepatitis B: A Real Life Cohort Study in Korea
    Ahn, Hyo Jun
    Song, Myeong Jun
    Jang, Jeong Won
    Bae, Si Hyun
    Choi, Jong Young
    Yoon, Seung Kew
    [J]. PLOS ONE, 2017, 12 (01):
  • [2] Long-term efficacy and safety of emtricitabine plus tenofovir DF vs. tenofovir DF monotherapy in adefovir-experienced chronic hepatitis B patients
    Berg, Thomas
    Zoulim, Fabien
    Moeller, Bernd
    Trinh, Huy
    Marcellin, Patrick
    Chan, Sing
    Kitrinos, Kathryn M.
    Dinh, Phillip
    Flaherty, John F., Jr.
    McHutchison, John G.
    Manns, Michael
    [J]. JOURNAL OF HEPATOLOGY, 2014, 60 (04) : 715 - 722
  • [3] Tenofovir Is Effective Alone or With Emtricitabine in Adefovir-Treated Patients With Chronic-Hepatitis B Virus Infection
    Berg, Thomas
    Marcellin, Patrick
    Zoulim, Fabien
    Moller, Bernd
    Trinh, Huy
    Chan, Sing
    Suarez, Emilio
    Lavocat, Fabien
    Snow-Lampart, Andrea
    Frederick, David
    Sorbel, Jeff
    Borroto-Esoda, Katyna
    Oldach, David
    Rousseau, Franck
    [J]. GASTROENTEROLOGY, 2010, 139 (04) : 1207 - +
  • [4] Long-term safety and efficacy of nucleo(t)side analogue therapy in hepatitis B
    Buti, Maria
    Riveiro-Barciela, Mar
    Esteban, Rafael
    [J]. LIVER INTERNATIONAL, 2018, 38 : 84 - 89
  • [5] Buti M, 2016, LANCET GASTROENTEROL, V1, P90, DOI [10.1016/S2468-1253(16)30020-6, 10.1016/S2468-1253(16)30107-8]
  • [6] Seven-Year Efficacy and Safety of Treatment with Tenofovir Disoproxil Fumarate for Chronic Hepatitis B Virus Infection
    Buti, Maria
    Tsai, Naoky
    Petersen, Joerg
    Flisiak, Robert
    Gurel, Selim
    Krastev, Zahary
    Schall, Raul Aguilar
    Flaherty, John F.
    Martins, Eduardo B.
    Charuworn, Prista
    Kitrinos, Kathryn M.
    Subramanian, G. Mani
    Gane, Edward
    Marcellin, Patrick
    [J]. DIGESTIVE DISEASES AND SCIENCES, 2015, 60 (05) : 1457 - 1464
  • [7] Tenofovir-based rescue therapy in chronic hepatitis B patients with suboptimal responses to adefovir with prior lamivudine resistance
    Cho, Hyo Jung
    Kim, Soon Sun
    Shin, Sung Jae
    Yoo, Byung Moo
    Cho, Sung Won
    Cheong, Jae Youn
    [J]. JOURNAL OF MEDICAL VIROLOGY, 2015, 87 (09) : 1532 - 1538
  • [8] Tenofovir has inferior efficacy in adefovir-experienced chronic hepatitis B patients compared to nucleos(t)ide naive patients
    Chung, Goh Eun
    Cho, Eun Ju
    Lee, Jeong-Hoon
    Yoo, Jeong-ju
    Lee, Minjong
    Cho, Yuri
    Lee, Dong Hyeon
    Kim, Hwi Young
    Yu, Su Jong
    Kim, Yoon Jun
    Yoon, Jung-Hwan
    Zoulim, Fabien
    [J]. CLINICAL AND MOLECULAR HEPATOLOGY, 2017, 23 (01) : 66 - 73
  • [9] The case of chronic hepatitis B treatment with tenofovir: an update for nephrologists
    Coppolino, Giuseppe
    Simeoni, Mariadelina
    Summaria, Chiara
    Postorino, Maria Concetta
    Rivoli, Laura
    Strazzulla, Alessio
    Torti, Carlo
    Fuiano, Giorgio
    [J]. JOURNAL OF NEPHROLOGY, 2015, 28 (04) : 393 - 402
  • [10] No Resistance to Tenofovir Disoproxil Fumarate Through 96 Weeks of Treatment in Patients With Lamivudine-Resistant Chronic Hepatitis B
    Corsa, Amoreena C.
    Liu, Yang
    Flaherty, John F.
    Ben Mitchell
    Fung, Scott K.
    Gane, Edward
    Miller, Michael D.
    Kitrinos, Kathryn M.
    [J]. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2014, 12 (12) : 2106 - U393