Erdem Bektas, Aysenur Yilmaz, Cevat Ilteris Kikili, Kanan Nuriyev, Zulal Istemihan, Ibrahim Volkan Senkal, Ziya Imanov, Bilger Cavus, Asli Cifcibasi Ormeci, Filiz Akyuz, Kadir Demir, Selman Fatih Besisik, Sabahattin Kaymakoglu
{"title":"Real World Efficacy and Safety of Switching From Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in Liver Transplant Recipients.","authors":"Erdem Bektas, Aysenur Yilmaz, Cevat Ilteris Kikili, Kanan Nuriyev, Zulal Istemihan, Ibrahim Volkan Senkal, Ziya Imanov, Bilger Cavus, Asli Cifcibasi Ormeci, Filiz Akyuz, Kadir Demir, Selman Fatih Besisik, Sabahattin Kaymakoglu","doi":"10.1111/tid.70068","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of nucleos(t)ide analogs is currently a critical issue in the treatment of hepatitis B virus infection. We aimed to investigate the long-term efficacy and safety profile of tenofovir alafenamide (TAF) treatment in the liver transplant recipients (LTRs).</p><p><strong>Methods: </strong>This retrospective study was conducted with 72 LTRs who received TAF as sequential therapy after tenofovir disoproxil fumarate (TDF). The renal, metabolic outcomes, and efficacy of TAF were evaluated. In addition, some parameters were evaluated separately according to the use of calcineurin inhibitors.</p><p><strong>Results: </strong>Following TAF treatment, median serum phosphorus levels and estimated glomerular filtration rate (eGFR) increased significantly in the overall cohort (from 2.4 to 2.85 mg/dL [p < 0.001]; from 66 to 74 mL/min/1.73 m<sup>2</sup> [p = 0.028], respectively). These improvements were more pronounced in patients with baseline hypophosphatemia and reduced eGFR. However, no significant changes were observed in eGFR staging. A categorical worsening of lipid profile was noted based on the NCEP ATP-III criteria, with increases in some lipid parameters. No significant weight gain or increase in the incidence of posttransplant diabetes mellitus was observed. Antiviral efficacy was maintained following the switch from TDF to TAF. In addition, no significant changes in immunosuppressive drug dosing were required, and no adverse events related to TAF were reported.</p><p><strong>Conclusion: </strong>TAF was well-tolerated and effective in LTRs. The long-term benefits of TAF on hypophosphatemia, renal function, and effective viral suppression were demonstrated. The patients with an increased risk of cardiovascular disease should receive more intensive monitoring for changes in their lipid profile.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70068"},"PeriodicalIF":2.6000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant Infectious Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/tid.70068","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The efficacy and safety of nucleos(t)ide analogs is currently a critical issue in the treatment of hepatitis B virus infection. We aimed to investigate the long-term efficacy and safety profile of tenofovir alafenamide (TAF) treatment in the liver transplant recipients (LTRs).
Methods: This retrospective study was conducted with 72 LTRs who received TAF as sequential therapy after tenofovir disoproxil fumarate (TDF). The renal, metabolic outcomes, and efficacy of TAF were evaluated. In addition, some parameters were evaluated separately according to the use of calcineurin inhibitors.
Results: Following TAF treatment, median serum phosphorus levels and estimated glomerular filtration rate (eGFR) increased significantly in the overall cohort (from 2.4 to 2.85 mg/dL [p < 0.001]; from 66 to 74 mL/min/1.73 m2 [p = 0.028], respectively). These improvements were more pronounced in patients with baseline hypophosphatemia and reduced eGFR. However, no significant changes were observed in eGFR staging. A categorical worsening of lipid profile was noted based on the NCEP ATP-III criteria, with increases in some lipid parameters. No significant weight gain or increase in the incidence of posttransplant diabetes mellitus was observed. Antiviral efficacy was maintained following the switch from TDF to TAF. In addition, no significant changes in immunosuppressive drug dosing were required, and no adverse events related to TAF were reported.
Conclusion: TAF was well-tolerated and effective in LTRs. The long-term benefits of TAF on hypophosphatemia, renal function, and effective viral suppression were demonstrated. The patients with an increased risk of cardiovascular disease should receive more intensive monitoring for changes in their lipid profile.
期刊介绍：
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
