TAF治疗肾移植受者的长期骨和肾安全性。

IF 4.1 3区 医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Desmond Y H Yap, Cheng-Kun Wu, Colin Tang, Kuo-Chin Chang, Wen-Chin Lee, David T W Lui, Maggie K M Ma, Tsung-Hui Hu, Tak Mao Chan
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引用次数: 0

摘要

理由与目的:替诺福韦阿拉芬胺(TAF)在慢性乙型肝炎病毒(HBV)感染肾移植受者(KTRs)中的应用数据有限。研究设计:回顾性队列研究设置和研究人群:在2019年至2022年期间接受TAF治疗的hbsag阳性ktr患者被纳入分析,分为treatment-naïve和治疗经验组。此外,对接受ETV治疗的患者进行亚组分析以进行比较。结果:4例treatment-naïve (I组)和35例有治疗经验的患者(II组)分别接受TAF治疗26.4±11.3和43.7±19.0个月。两组均有显著的HBV DNA降低,但组I的HBV DNA不可检出率更高(6、12、24、30个月时为50%、75%、75%、100%,而组II的不可检出率分别为16.7%、25.3%、31.4%、34.7%,p=0.018)。在随访期间,同种异体肾移植功能保持稳定,骨毒性最小。对于ETV, 10例患者表现出出色的病毒抑制(48周时70%无法检测到HBV DNA, 96周时100%无法检测到),肾功能稳定,中位时间为5.2年。局限性:回顾性研究缺乏TAF和ETV的前瞻性比较。结论:我们的研究结果表明TAF在KTRs中具有良好的疗效、肾脏安全性和耐受性。ETV还提供了有效和持续的病毒抑制。TAF可能提供额外的优势,如不担心病毒耐药性和根据eGFR水平调整剂量,用于hbsag阳性ktr的长期管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A long term bone and renal safety of TAF treatment on renal transplant recipients.

Rationale & objective: The data on tenofovir alafenamide (TAF) in kidney transplant recipients (KTRs) with chronic hepatitis B virus (HBV) infection is limited.

Study design: Retrospective cohort study SETTING & STUDY POPULATIONS: HBsAg-positive KTRs who received TAF between 2019 and 2022 were included in the analysis, categorized into treatment-naïve and treatment-experienced groups. Additionally, a subgroup of patients receiving ETV was analyzed for comparison.

Results: Four treatment-naïve (Group I) and 35 treatment-experienced (Group II) patients received TAF for 26.4±11.3 and 43.7±19.0 months, respectively. Both groups showed significant HBV DNA reduction, but Group I achieved higher rates of undetectable HBV DNA (50%, 75%, 75%, 100% at 6, 12, 24, 30 months, compared with 16.7%, 25.3%, 31.4%, 34.7% in Group II, p=0.018). Renal allograft function remained stable during follow-up, and bone toxicity was minimal. For ETV, 10 patients demonstrated excellent viral suppression (HBV DNA undetectable in 70% at 48 weeks and 100% at 96 weeks) with stable renal function over a median of 5.2 years.

Limitations: Retrospective study with a lack of prospective comparison of TAF and ETV.

Conclusions: Our results suggest that TAF provides favorable efficacy, renal safety, and tolerability in KTRs. ETV also provided effective and sustainable viral suppression. TAF may offer additional advantages such as no concern of viral resistance and dose adjustment by eGFR levels for long-term management of HBsAg-positive KTRs.

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来源期刊
Biomedical Journal
Biomedical Journal Medicine-General Medicine
CiteScore
11.60
自引率
1.80%
发文量
128
审稿时长
42 days
期刊介绍: Biomedical Journal publishes 6 peer-reviewed issues per year in all fields of clinical and biomedical sciences for an internationally diverse authorship. Unlike most open access journals, which are free to readers but not authors, Biomedical Journal does not charge for subscription, submission, processing or publication of manuscripts, nor for color reproduction of photographs. Clinical studies, accounts of clinical trials, biomarker studies, and characterization of human pathogens are within the scope of the journal, as well as basic studies in model species such as Escherichia coli, Caenorhabditis elegans, Drosophila melanogaster, and Mus musculus revealing the function of molecules, cells, and tissues relevant for human health. However, articles on other species can be published if they contribute to our understanding of basic mechanisms of biology. A highly-cited international editorial board assures timely publication of manuscripts. Reviews on recent progress in biomedical sciences are commissioned by the editors.
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