Estimated Glomerular Filtration Rate Increases in Chronic Hepatitis B Patients Treated With Telbivudine Monotherapy and Combination Treatment

Overview

Journal Hepat Mon

Publisher Brieflands

Specialty Gastroenterology

Date 2016 Apr 26

PMID 27110258

Citations 1

Authors

Libin Jiang

Song Hu

Man He

Deying Tian

Affiliations

Soon will be listed here.

Abstract

Background: Several studies have reported a renoprotective effect of telbivudine during the treatment of patients for chronic hepatitis B (CHB).

Objectives: This longitudinal retrospective study aimed to examine the effects of telbivudine monotherapy and combination therapy (adefovir plus telbivudine) on renal function.

Patients And Methods: This study included 336 Chinese CHB patients, who were selected from outpatients in Tongji Hospital. 44, 122, 66, 58, and 46 of these patients had been orally taking adefovir, telbivudine, entecavir, adefovir plus telbivudine, and adefovir plus lamivudine, respectively, for at least 24 months.

Results: The estimated glomerular filtration rate (eGFR) in the telbivudine and adefovir plus telbivudine groups increased by 5.14 mL/min (P < 0.001) and 6.19 mL/min (P = 0.005), respectively. The patients taking the five drug regimens were further grouped into the following three subpopulations: those with compensated hepatic cirrhosis, those aged 50 or more years, and those with baseline eGFR values of 50 - 90 mL/min. The three subgroups that received telbivudine monotherapy exhibited eGFR increases of 6.38, 6.74, and 10.82 mL/min, respectively. The three subgroups that received combination therapy of adefovir plus telbivudine exhibited eGFR increases of 18.31, 14.73, and 16.59 mL/min, respectively (P < 0.05). The predictive factors for the change in eGFR levels over time were analyzed by means of two linear mixed effects models for the three monotherapy regimens and two combination regimens. Age, gender, and medication are predictive factors of eGFR changes. In addition, abnormal creatinine kinase (CK) levels in the telbivudine group were not correlated with eGFR changes (P = 0.992).

Conclusions: These findings indicate that telbivudine, used in both monotherapy and combination therapy, improves the renal function of patients with CHB. The improvements are particularly significant in patients at high renal risk.

Citing Articles

Telbivudine for renal transplant recipients with chronic hepatitis B infection: a randomized controlled trial with early termination.

Yang Y, Tsai M, Yang C, Lee C, Chiang B, Lai H Clin Exp Nephrol. 2020; 24(5):474-482.

PMID: 32219622 DOI: 10.1007/s10157-020-01850-7.

References

Hadziyannis S, Tassopoulos N, Heathcote E, Chang T, Kitis G, Rizzetto M . Long-term therapy with adefovir dipivoxil for HBeAg-negative chronic hepatitis B. N Engl J Med. 2005; 352(26):2673-81. DOI: 10.1056/NEJMoa042957. View

Fontana R . Side effects of long-term oral antiviral therapy for hepatitis B. Hepatology. 2009; 49(5 Suppl):S185-95. DOI: 10.1002/hep.22885. View

Nelson M, Katlama C, Montaner J, Cooper D, Gazzard B, Clotet B . The safety of tenofovir disoproxil fumarate for the treatment of HIV infection in adults: the first 4 years. AIDS. 2007; 21(10):1273-81. DOI: 10.1097/QAD.0b013e3280b07b33. View

Cholongitas E, Vasiliadis T, Goulis I, Fouzas I, Antoniadis N, Papanikolaou V . Telbivudine is associated with improvement of renal function in patients transplanted for HBV liver disease. J Viral Hepat. 2014; 22(7):574-80. DOI: 10.1111/jvh.12362. View

Hsu H, Lin G, Chang M, Chen C . Association of hepatitis B surface (HBs) antigenemia and membranous nephropathy in children in Taiwan. Clin Nephrol. 1983; 20(3):121-9. View

Zou X, Jiang X, Tian D . Clinical features and risk factors of creatine kinase elevations and myopathy associated with telbivudine. J Viral Hepat. 2011; 18(12):892-6. DOI: 10.1111/j.1365-2893.2010.01412.x. View

Ha N, Ha N, Garcia R, Trinh H, Vu A, Nguyen H . Renal dysfunction in chronic hepatitis B patients treated with adefovir dipivoxil. Hepatology. 2009; 50(3):727-34. DOI: 10.1002/hep.23044. View

Lampertico P, Vigano M, Manenti E, Iavarone M, Sablon E, Colombo M . Low resistance to adefovir combined with lamivudine: a 3-year study of 145 lamivudine-resistant hepatitis B patients. Gastroenterology. 2007; 133(5):1445-51. DOI: 10.1053/j.gastro.2007.08.079. View

Levey A, Stevens L, Schmid C, Zhang Y, Castro 3rd A, Feldman H . A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150(9):604-12. PMC: 2763564. DOI: 10.7326/0003-4819-150-9-200905050-00006. View

10.

Levey A, Coresh J, Balk E, Kausz A, Levin A, Steffes M . National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003; 139(2):137-47. DOI: 10.7326/0003-4819-139-2-200307150-00013. View

11.

Liang K, Chen Y, Hsu C, Chang M, Yeh C . Decrease of serum Angiotensin converting enzyme levels upon telbivudine treatment for chronic hepatitis B virus infection and negative correlations between the enzyme levels and estimated glumerular filtration rates. Hepat Mon. 2014; 14(1):e15074. PMC: 3929862. DOI: 10.5812/hepatmon.15074. View

12.

Tanji N, Tanji K, Kambham N, Markowitz G, Bell A, DAgati V . Adefovir nephrotoxicity: possible role of mitochondrial DNA depletion. Hum Pathol. 2001; 32(7):734-40. DOI: 10.1053/hupa.2001.25586. View

13.

Yang Y, Xiong Q, Zhao W, Zhong Y . Complete remission of hepatitis B virus-related membranous nephropathy after entecavir monotherapy. Clin Res Hepatol Gastroenterol. 2012; 36(5):e89-92. DOI: 10.1016/j.clinre.2012.03.033. View

14.

Izzedine H, Isnard-Bagnis C, Hulot J, Vittecoq D, Cheng A, Jais C . Renal safety of tenofovir in HIV treatment-experienced patients. AIDS. 2004; 18(7):1074-6. DOI: 10.1097/00002030-200404300-00019. View

15.

Amet S, Bronowicki J, Thabut D, Zoulim F, Bourliere M, Mathurin P . Prevalence of renal abnormalities in chronic HBV infection: the HARPE study. Liver Int. 2014; 35(1):148-55. DOI: 10.1111/liv.12480. View

16.

Peng C, Chien R, Liaw Y . Hepatitis B virus-related decompensated liver cirrhosis: benefits of antiviral therapy. J Hepatol. 2012; 57(2):442-50. DOI: 10.1016/j.jhep.2012.02.033. View

17.

Lai C, Gane E, Liaw Y, Hsu C, Thongsawat S, Wang Y . Telbivudine versus lamivudine in patients with chronic hepatitis B. N Engl J Med. 2007; 357(25):2576-88. DOI: 10.1056/NEJMoa066422. View

18.

Tang S, Lai F, Lui Y, Tang C, Kung N, Ho Y . Lamivudine in hepatitis B-associated membranous nephropathy. Kidney Int. 2005; 68(4):1750-8. DOI: 10.1111/j.1523-1755.2005.00591.x. View

19.

. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol. 2012; 57(1):167-85. DOI: 10.1016/j.jhep.2012.02.010. View

20.

Keith D, Nichols G, Gullion C, Brown J, Smith D . Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med. 2004; 164(6):659-63. DOI: 10.1001/archinte.164.6.659. View