title: Comparison of telbivudine and entecavir on the change of off- treatment eGFR after 3 years of treatment in non-cirrhotic chronic hepatitis B patients.
abstract: BACKGROUND
  The change of estimated glomerular filtration rate (eGFR) with off-treatment nucleos(t)ide analogues (NA) in chronic hepatitis B patients (CHB) is unclear. This study is aimed to evaluate the off-treatment eGFR after 3 years of therapy with telbivudine (LdT) or entecavir (ETV) and to assess predictive factors for eGFR improvement.
  
  
  METHODS
  From January 2009 to December 2011, we identified NA-naïve patients who were at least 20 years of age diagnosed with compensated CHB. All patients received a 3-year NA treatment and 1 year off-treatment follow-up; the initial selection of patients for LdT or ETV treatment was at the physicians' discretion. An increase of more than 10% in eGFR from the baseline was identified as an improvement. The change of chronic kidney disease stages were recorded and compared with baseline at year 3 and year 4, respectively.
  
  
  RESULTS
  This study included two groups consisting of 46 patients each (each with3 years of treatment with LdT or ETV). In LdT-treated patients, the mean eGFR increased from 94.3 ± 28.3 to 104.0 ± 31.2 mL/min/1.73 m2in year 3 (p = 0.01) and from 104.0 ± 31.2 to 104.0 ± 28.8 mL/min/1.73 m2in year 4 (p = 0.99). However, in ETV-treated patients, the mean eGFR decreased from 93.1 ± 26.1 to 85.5 ± 25.1 mL/min/1.73 m2in year 3 (p = 0.0009) and from 85.5 ± 25.1 to 87.7 ± 24.8 mL/min/1.73 m2in year 4 (p = 0.2). After a multivariate analysis, the predictors for the off-treatment eGFR improvement were the LdT treatment (odds ratio [OR], 3.97 (1.37-11.5), p = 0.01) and pre-treated eGFR (OR, 0.98 (0.95-1.00), p = 0.04).
  
  
  CONCLUSIONS
  At year 4, 48.8 and 21.3% patients had an improved eGFR from baseline in LdT and ETV patients, respectively. Telbivudine may have a protective renal effect that can last for one year after treatment in non-cirrhotic CHB patients without a virological breakthrough.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Campus, No. 92, Sec. 2, Chungshan North Road, 104, Taipei, Taiwan.|MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|MacKay Medical College, New Taipei City, Taiwan.
authors.forename: Yang-Sheng
authors.initials: YS
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Campus, No. 92, Sec. 2, Chungshan North Road, 104, Taipei, Taiwan.|MacKay Medical College, New Taipei City, Taiwan.
authors.forename: Shou-Chuan
authors.initials: SC
authors.lastname: Shih
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Campus, No. 92, Sec. 2, Chungshan North Road, 104, Taipei, Taiwan.|MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|MacKay Medical College, New Taipei City, Taiwan.
authors.forename: Horng-Yuan
authors.initials: HY
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Campus, No. 92, Sec. 2, Chungshan North Road, 104, Taipei, Taiwan.|MacKay Medical College, New Taipei City, Taiwan.
authors.forename: Ching-Chung
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Campus, No. 92, Sec. 2, Chungshan North Road, 104, Taipei, Taiwan.|MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|MacKay Medical College, New Taipei City, Taiwan.
authors.forename: Chen-Wang
authors.initials: CW
authors.lastname: Chang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Campus, No. 92, Sec. 2, Chungshan North Road, 104, Taipei, Taiwan. mingjen.ch@msa.hinet.net.|MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan. mingjen.ch@msa.hinet.net.|MacKay Medical College, New Taipei City, Taiwan. mingjen.ch@msa.hinet.net.
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Chen
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000077712:Telbivudine; C413685:entecavir; D006147:Guanine; D013936:Thymidine
keywords: Chronic hepatitis B; Entecavir; Off-treatment; Renal function; Telbivudine; eGFR