Original articlePancreas, biliary tract, and liverEffect of Nucleoside and Nucleotide Analogues on Renal Function in Patients With Chronic Hepatitis B Virus Monoinfection
Section snippets
Study Design
We selected from an integrated database of 2485 patients with HBV a retrospective cohort of patients with chronic HBV infection who received specific treatment between 1990 and 2012 at a single hepatology unit in a tertiary care center in France (Supplementary Figure 1).
We included patients who met the following criteria: chronic HBV infection treated with NUC; absence of hepatitis C and hepatitis D co-infection; absence of liver-related complication, including ascites, hepatic encephalopathy,
Sample
The cohort comprised 214 patients with chronic HBV infection without co-infection, without immunodepression, and without more than 1 life-threatening condition described in the Charlson–Deyo index, including end-stage liver disease and hepatocellular carcinoma (Supplementary Figure 1). The median age was 43 years; two-thirds were men and one-fourth was of Asian ethnic origin. Approximately 10% of patients had 1 or more risk factors of CKD, including diabetes, obesity, hyperlipidemia, and high
Discussion
The BeSafe observational study was designed to assess renal function variations of chronic HBV patients with first- and second-generation nucleo(s)tide analogue treatment. We used a linear mixed model adjusted for preexisting comorbidities, geographic origin, and initial viral load to measure the individual variations of the eGFR computed with the Chronic Kidney Disease Epidemiology Collaboration formula. Although patients treated with ADV had a decreased eGFR over time, no renal impairment was
Acknowledgments
The authors thank Drs Yacia Benai and Raoudha Akremi for supporting this work, Dr Amel Sahli for her statistical advice, and Dr Philippe Sultanik for fruitful discussions.
References (31)
- et al.
Glomerulonephritis with deposition of Australia antigen-antibody complexes in glomerular basement membrane
Lancet
(1971) - et al.
Reversibility of hepatitis B virus-induced glomerulonephritis and chronic active hepatitis after spontaneous clearance of serum hepatitis B surface antigen
Gastroenterology
(1978) - et al.
Long-term outcome of hepatitis B virus-related glomerulonephritis after therapy with interferon alfa
Gastroenterology
(1995) EASL Clinical Practice Guidelines. Management of chronic hepatitis B virus infection
J Hepatol
(2012)Side effects of long-term oral antiviral therapy for hepatitis B
Hepatology
(2009)- et al.
Antiviral drug-induced kidney and electrolytes disorders
Minerva Urol Nefrol
(2003) - et al.
Telbivudine improves renal function in patients with chronic hepatitis B
Gastroenterology
(2014) - et al.
Effect of HBV polymerase inhibitors on renal function in patients with chronic hepatitis B
J Hepatol
(2011) - et al.
Similar risk of renal events among patients treated with tenofovir or entecavir for chronic hepatitis B
Clin Gastroenterol Hepatol
(2012) - et al.
Effectiveness and safety of tenofovir disoproxil fumarate in field practice: a multicenter European cohort study of 737 patients with chronic hepatitis B
Hepatology
(2010)
Evaluation of safety and tolerability of tenofovir DF (TDF) long term monotherapy in nucleos(t)ide analogue experienced patients with HBV monoinfection
J Hepatol
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chronic Dis
Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline
Ann Intern Med
Dyslipidaemia and the progression of renal disease in chronic renal failure patients
Nephrol Dial Transplant
Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: a clinical practice guideline from the American College of Physicians
Ann Intern Med
Cited by (0)
Reproducible research statement: study protocol, statistical code, and data set are available from Vincent Mallet after establishing written agreement with the authors: e-mail: [email protected].
Conflicts of interest These authors disclose the following: Stanislas Pol has served as a speaker for GSK, BMS, Boehringer Ingelheim, Janssen, Gilead, Roche, MSD, Sanofi, Novartis, Vertex, and AbbVie, has received grants from BMS, Gilead, Roche, and MSD, and is a board member of GSK, BMS, Boehringer Ingelheim, Janssen, Gilead, Roche, MSD, Sanofi, Novartis, Vertex, and AbbVie; Michael Schwarzinger has received a research grant from Novartis; Philippe Sogni has served as a speaker for BMS, Gilead, Roche, Janssen, and Merck and Co, and has served as a board member of Gilead, Merck and Co, and Janssen; Vincent Mallet has served as a speaker for BMS, Gilead, Roche, Janssen, and Merck and Co, and has served as a board member of Gilead, Merck and Co, and Janssen; Hélène Fontaine has served as a speaker for BMS, Gilead, Abbvie, Roche and Janssen, and has served as a board member for Gilead and BMS; and Anaïs Vallet Pichard has served as a speaker for Gilead, Roche, BMS, Merck and Co, Abbvie, and Janssen. The remaining authors disclose no conflicts.
Funding The BeSafe study was funded with an unrestricted grant from Bristol-Myers Squibb.