Is tenofovir disoproxil nephrotoxic in all patients? side effects of tenofovir and entecavir on kidney

Authors

  • Jehat Kiliç Department of Internal Medicine, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
  • Feyzullah Uçmak Department Gastroenterology, Dicle University, Diyarbakir, Turkey
  • Delyadıl Karakaş Kiliç Department of Internal Medicine, Halis Toprak State Hospital, Diyarbakir, Turkey
  • Berat Ebik Department Gastroenterology, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey

DOI:

https://doi.org/10.18203/2320-6012.ijrms20221967

Keywords:

Entecavir, Tenofovir, GFR, Chronic hepatitis B

Abstract

Background: Hepatit B virus (HBV) is one of the main causes of liver related morbidity and mortality in worldwide. This condition is also a significant healthcare problem in Turkey. Entecavir (ETV) and tenofovir (TDF) are potent nucleos(t)ide analogues (NAs) recommended for the treatment of chronic HBV (CHB) infection. The aim of the study was to determine the association of NAs and nephrotoxicity in our CHB cohort.

Methods: Between the January 2011-February 2021, there were 294 patients treated with TDF (N=194) and ETV (N=100). Glomerular filtration rate (GFR) was calculated by the modification of diet in renal disease (MDRD) method. Kidney function tests were assessed at baseline and follow-up visits.

Results: There were 294 patients in the total group. The mean follow-up period was 66±18 months. Age and sex distributions and baseline assessments including liver function tests, creatinine, GFR, HBV DNA values and pathology scores (HAI and fibrosis) were similar between TDF (N=194) and ETV (N=100) groups. Creatinin and GFR assessed at the last visit were 0.81±0.01 g/dl and 102.94±19.78 ml/min for TDF and 0.81±0.013 g/dl and 104.65±19.05 ml/min for ETV. These values were not significant between the both treatment groups. In terms of nephrotoxicity, none of the patients had significant changes in terms of creatinine and GFR that may require dose adjustment.

Conclusions: We showed that the use of both drugs led to a decrease in GFR that was not clinically important in chronic hepatitis B patients with normal baseline renal tests and without co-morbidity.

References

Maynard JE. Hepatitis B: global importance and need for control. Vaccine. 1990;8:18-20.

Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30(12):2212-9.

Anna SF, Lok MD. Hepatitis B virus: Screening and diagnosis Uptodate, 2018. Available at: asld.org/sites/default/files/201906/HBVGuidance_Terrault_et_al-2018-Hepatology. Accessed on 01 June 2022.

Challine D, Chevaliez S, Pawlotsky JM. Efficacy of serologic marker screening in identifying hepatitis B virus infection in organ, tissue, and cell donors. Gastroenterology. 2008;135(4):1185-91.

Brook G, Soriano V, Bergin C. European guideline for the management of hepatitis B and C virus infections, 2010. Int J STD AIDS. 2010;21(10):669-78.

Liaw YF, Kao JH, Piratvisuth T, Chan HL, Chien RN, Liu CJ, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int. 2012;6(3):531-61.

Terrault NA, Bzowej NH, Chang KM, Hwang JP, Jonas MM, Murad MH, et al. AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2016;63(1):261-83.

European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu; European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370-98.

Novick TK, Choi MJ, Rosenberg AZ, McMahon BA, Fine D, Atta MG. Tenofovir alafenamide nephrotoxicity in an HIV-positive patient: A case report. Medicine (Baltimore). 2017;96(36):e8046.

Novick TK, Choi MJ, Rosenberg AZ, McMahon BA, Fine D, Atta MG. Tenofovir alafenamide nephrotoxicity in an HIV-positive patient: A case report. Medicine (Baltimore). 2017;96(36):e8046.

Shin JH, Kwon HJ, Jang HR, Lee JE, Gwak GY, Huh W, Jung SH, et al. Risk Factors for Renal Functional Decline in Chronic Hepatitis B Patients Receiving Oral Antiviral Agents. Medicine (Baltimore). 2016;95(1):e2400.

Mak LY, Seto WK, Lai CL, Yuen MF. DNA polymerase inhibitors for treating hepatitis B: a safety evaluation. Expert Opin Drug Saf. 2016;15(3):383-92.

Gallant JE, Parish MA, Keruly JC, Moore RD. Changes in renal function associated with tenofovir disoproxil fumarate treatment, compared with nucleoside reverse-transcriptase inhibitor treatment. Clin Infect Dis. 2005;40(8):1194-8.

Aloy B, Tazi I, Bagnis CI, Gauthier M, Janus N, Launay-Vacher V, et al. Is Tenofovir Alafenamide Safer than Tenofovir Disoproxil Fumarate for the Kidneys? AIDS Rev. 2016;18(4):184-92.

Yang YM, Choi EJ. Renal safety of tenofovir and/or entecavir in patients with chronic HBV monoinfection. Ther Clin Risk Manag. 2017;13:1273-85.

Wu IT, Hu TH, Hung CH, Lu SN, Wang JH, Lee CM, et al. Comparison of the efficacy and safety of entecavir and tenofovir in nucleos(t)ide analogue-naive chronic hepatitis B patients with high viraemia: a retrospective cohort study. Clin Microbiol Infect. 2017;23(7):464-9.

Pipili C, Cholongitas E, Papatheodoridis G. Review article: nucleos(t)ide analogues in patients with chronic hepatitis B virus infection and chronic kidney disease. Aliment Pharmacol Ther. 2014;39(1):35-46.

Downloads

Published

2022-07-27

How to Cite

Kiliç, J., Uçmak, F., Kiliç, D. K., & Ebik, B. (2022). Is tenofovir disoproxil nephrotoxic in all patients? side effects of tenofovir and entecavir on kidney. International Journal of Research in Medical Sciences, 10(8), 1601–1605. https://doi.org/10.18203/2320-6012.ijrms20221967

Issue

Section

Original Research Articles