title: Effect of HBV polymerase inhibitors on renal function in patients with chronic hepatitis B.
abstract: OBJECTIVE
  Therapy of chronic hepatitis B with HBV-polymerase inhibitors, in particular tenofovir or adefovir, may affect renal function. To assess renal function more accurately in the normal range, we used the recently validated, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula to calculate the estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  Patient subgroups included: patients with HBV-monoinfection treated with lamivudine (n=36), adefovir (n=32), entecavir (n=32), or tenofovir (n=37). HBsAg-positive untreated patients (n=60) served as control. For comparison HIV-monoinfected patients treated with tenofovir (n=120) or zidovudine (n=52) based antiretroviral therapy and antiretroviral naive patients (n=109) were assessed. CKD-EPI equation was used to calculate eGFR. In a more sensitive approach, we modeled the individual change in eGFR over time with linear mixed effects models (LME).
  
  
  RESULTS
  Yearly predicted median changes in individual eGFR according to the LME model were: HBV untreated -2.05 ml/min, HBV lamivudine -0.92 ml/min, HBV adefovir -1.02 ml/min, HBV entecavir -1.00 ml/min, and HBV tenofovir -0.92 ml/min (p<0.01 for HBV untreated vs. HBV treated). In HIV-monoinfected patients: HIV untreated -0.62 ml/min, HIV treated with tenofovir -2.64 ml/min, HIV treated with zidovudine -1.0 ml/min (p=0.017 for tenofovir vs. no treatment, p<0.001 for tenofovir vs. zidovudine).
  
  
  CONCLUSIONS
  Therapy of HBV infection irrespective of medication seems to result in a milder decrease of renal function. In contrast tenofovir as part of HIV combination therapy seems to impair renal function in this Caucasian population.
authors.affiliation: Center for HIV and Hepatogastroenterology, Duesseldorf, Germany. stefan.mauss@center-duesseldorf.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Mauss
authors.forename: Florian
authors.initials: F
authors.lastname: Berger
authors.forename: Natalie
authors.initials: N
authors.lastname: Filmann
authors.forename: Dietrich
authors.initials: D
authors.lastname: Hueppe
authors.forename: Julia
authors.initials: J
authors.lastname: Henke
authors.forename: Petra
authors.initials: P
authors.lastname: Hegener
authors.forename: Christoph
authors.initials: C
authors.lastname: Athmann
authors.forename: Guenther
authors.initials: G
authors.lastname: Schmutz
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D015684:Gene Products, pol / Q000037:antagonists & inhibitors*; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000068698:Tenofovir; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D015684:Gene Products, pol; D063065:Organophosphonates; C066027:P protein, Hepatitis B virus; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D000225:Adenine