Tenofovir Alafenamide Rescues Renal Tubules in Patients with Chronic Hepatitis B

Sano, Tomoya; Kawaguchi, Takumi; Ide, Tatsuya; Amano, Keisuke; Kuwahara, Reiichiro; Arinaga‐Hino, Teruko; Torimura, Takuji

doi:10.3390/life11030263

Cited by 4 publications

(4 citation statements)

References 58 publications

(86 reference statements)

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“…Renal safety is a major concern in long-term TDF therapy, especially in older patients or patients with renal impairment ( Lampertico et al, 2017 ). TDF can induce renal tubular dysfunction, but the detailed mechanism is unclear ( Sano et al, 2021 ). TAF is a prodrug of tenofovir (TFV) that has less renal toxicity than TDF.…”

Section: Discussionmentioning

confidence: 99%

Real-world experience of switching from tenofovir disoproxil fumarate to tenofovir alafenamide in patients with chronic hepatitis B: a retrospective study

Hsu

et al. 2021

PeerJ

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Background Tenofovir alafenamide (TAF) has good viral suppression efficacy and less adverse effect than tenofovir disoproxil fumarate (TDF). Real-world studies on the antiviral efficacy and safety of switching from TDF to TAF in patients with chronic hepatitis B (CHB) are limited. Methods This retrospective study included 167 nucleos(t)ide analogue (NA)-naive patients with CHB. All the patients received TDF at least 12 months before switching and TAF at least 12 months after switching at a single medical center. The Friedman test with Dunn–Bonferroni post hoc tests and repeated-measures analysis of variance was used to analyze the effect of complete viral suppression, alanine aminotransferase (ALT) level normalization, renal function changes, body weight, and body mass index in the periods before and after switching. Results The mean age and TDF treatment duration were 52 ± 11 years and 2.8 years (interquartile range, 1.51–5.15 years), respectively. The complete viral suppression rate was similar between the time of switching and 48 weeks after switching to TAF (77.8% vs 76%, P = 1.000). The percentage of alanine aminotransferase (ALT) normalization increased from 26.3% at TDF start to 81.4% (P < 0.001) at time of switching and 89.2% at 48 weeks after switching to TAF (P = 0.428). The median estimated glomerular filtration rate decreased from 100.09 mL/min/1.73 m² at TDF start to 91.97 mL/min/1.73 m² (P < 0.001) at the time of switching and stabilized at 48 weeks after switching to TAF (93.47 mL/min/1.73m², P = 1.000). The body weight decreased from 69.2 ± 12.2 kg at TDF start to 67.4 ± 12.1 kg (P < 0.001) at the time of switching to TAF and returned to 68.7 ± 12.7 kg (P < 0.001) 48 weeks thereafter. The body mass index (BMI) decreased from 25 ± 3.3 kg/m² at TDF start to 24.5 ± 3.3 kg/m² (P = 0.002) at the time of switching to TAF and returned to 25.1 ± 3.6 kg/m² (P < 0.001) 48 weeks thereafter. Conclusions Our study showed that switching to TAF from TDF had good antiviral effectiveness and stabilized renal function. The body weight and BMI decreased during TDF therapy and regained after switching to TAF.

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Section: Discussionmentioning

confidence: 99%

Real-world experience of switching from tenofovir disoproxil fumarate to tenofovir alafenamide in patients with chronic hepatitis B: a retrospective study

Hsu

et al. 2021

PeerJ

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“…TAF is a newer generation nucleoside analog that is a prodrug of tenofovir that results in up to 90% less systemic drug exposure than TDF. 7 There is emerging data to support its safety as an alternative in patients that develop renal complications on TDF. 8 However, there have been reports of TAF-induced FS have also been cited.…”

Section: Discussionmentioning

confidence: 99%

Fanconi Syndrome Induced by Concomitant HIV PrEP and Tacrolimus

Linn

Vandiver

Ren

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Fanconi syndrome (FS) is a severe grade of drug-induced proximal tubule toxicity. There are numerous causes for acquired FS, and drug toxicity is one of the most common. FS is known to be associated with the nucleoside reverse transcriptase inhibitor (NRTI) tenofovir disoproxil fumarate (TDF). TDF is often used in combination with emtricitabine (FTC) for preexposure prophylaxis (PrEP) of human immunodeficiency virus (HIV) infection. TDF/FTC-induced FS has been observed as a dose-related phenomenon that is directly correlated to kidney function, high levels of absorption of the drug into the proximal tubule, and interactions with other medications. This case report describes a patient who acquired FS after starting TDF/FTC for PrEP in the setting of chronic kidney disease (CKD) with concomitant tacrolimus therapy, a known nephrotoxic agent.

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“…tubular cells (18,19). Previous research underscores that tenofovir-related kidney injury is dose-dependent, with elevated TFV plasma concentrations correlating with an increased risk of renal damage (15,20,21).…”

Section: Mini-reviewmentioning

confidence: 99%

Renal safety of tenofovir alafenamide-based antiretroviral therapy in people with HIV: A mini-review

Zhao,

2024

BST

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Tenofovir Alafenamide Rescues Renal Tubules in Patients with Chronic Hepatitis B

Cited by 4 publications

References 58 publications

Real-world experience of switching from tenofovir disoproxil fumarate to tenofovir alafenamide in patients with chronic hepatitis B: a retrospective study

Real-world experience of switching from tenofovir disoproxil fumarate to tenofovir alafenamide in patients with chronic hepatitis B: a retrospective study

Fanconi Syndrome Induced by Concomitant HIV PrEP and Tacrolimus

Renal safety of tenofovir alafenamide-based antiretroviral therapy in people with HIV: A mini-review

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