替诺福韦-阿拉芬酰胺
医学
恩替卡韦
阿德福韦
内科学
乙型肝炎
前瞻性队列研究
胃肠病学
肾功能
慢性肝炎
肾脏疾病
内分泌学
泌尿科
免疫学
病毒载量
拉米夫定
人类免疫缺陷病毒(HIV)
病毒
抗逆转录病毒疗法
作者
Tetsuya Hosaka,Fumitaka Suzuki,Masahiro Kobayashi,Shunichiro Fujiyama,Yusuke Kawamura,Hitomi Sezaki,Norio Akuta,Yoshiyuki Suzuki,Satoshi Saitoh,Yasuji Arase,Kenji Ikeda,Mariko Kobayashi,Hiromitsu Kumada
摘要
Long-term use of nucleotide analogs such as adefovir (ADV) or tenofovir disoproxil fumarate (TDF) may cause renal impairment. Tenofovir alafenamide (TAF) has less systemic exposure than TDF did. The aims were to examine longitudinal changes in renal function and biochemical parameters for 2 years after switching from long-term ADV and TDF to TAF, and to explore factors associated with improved renal function after TAF in patients with chronic hepatitis B.The prospective observational cohort study included 306 patients with chronic hepatitis B who underwent switching from long-term TDF or ADV to TAF. The primary outcome was the changes in estimated glomerular filtration rate (eGFR) after TAF.Among 306 patients, 190 (65.3%) and 106 (34.7%) had chronic kidney disease (CKD) stages 1-2 and 3a-4 at baseline. In patients with CKD stages 3a-4, the mean eGFR significantly increased until week 12 and plateaued from week 12 to year 2 (adjusted slope using linear mixed effect models: +9.01 ml/min/1.73 m2 /year until week 12; p < 0.001). In contrast, the mean eGFR plateaued from baseline to year 2 in the CKD stages 1-2 subgroup. Multivariate logistic regression showed that baseline CKD stage ≥3a, steeper decline in eGFR 1 year before TAF, and shorter duration of any nucleotide analog use was significantly associated with ≥10% improvement in eGFR in year 1.Switching from TDF or ADV to TAF resulted in favorable renal safety for 2 years. In CKD stage 3a-4 subgroup, eGFR after TAF was recovered in the first 12 weeks and subsequently stabilized.
科研通智能强力驱动
Strongly Powered by AbleSci AI