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IF 2.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2025-02-27 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S497550

Yu Li, Ya-Wei Li, Ying Gao

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引用次数: 0

摘要

背景：恩替卡韦（ETV）、富马酸替诺福韦二吡呋酯（TDF）和替诺福韦阿拉非那胺（TAF）是治疗慢性乙型肝炎（CHB）的一线核苷酸类似物（NUC）。本研究旨在评估接受 ETV、TDF 或 TAF 治疗的有 NUC 经验的 CHB 患者的肾脏安全性：这项回顾性观察性队列研究调查了154名接受ETV、TDF和TAF治疗48周的有NUC经历的CHB患者的肾功能相关因素。研究采用单因素方差分析法分析了UREA、尿酸（UA）、肌酐（Cr）和估计肾小球滤过率（eGFR）的变化。重复测量的线性混合效应模型用于评估基线信息与开始治疗 48 周后 eGFR 变化之间的相关性。该模型将性别、基线年龄、病毒载量、转氨酶、肾功能和治疗组作为固定效应，并纳入了单个受试者的随机效应：结果：在治疗过程中，UA 或 Cr 水平随时间变化无明显差异。ETV 治疗患者的 eGFR 水平升高（117.5 ± 16.65 mL/min/1.7m2 vs 109.8 ± 15.69 mL/min/1.7m2，P=0.027），而 TDF 治疗患者的 eGFR 水平变化不大（123.6 ± 28.54 mL/min/1.7m2 vs 115.5 ± 20.44 mL/min/1.7m2, P=0.070）和TAF治疗（121.6 ± 23.44 mL/min/1.7m2 vs 113.4 ± 16.90 mL/min/1.7m2，P=0.053）的患者没有明显变化。较年轻的患者（7 log10IU/mL）和较低的丙氨酸氨基转移酶水平（PConclusion：根据实际经验，对于无基线肾功能损害的有 NUC 经验的慢性乙型肝炎患者，ETV、TDF 和 TAF 治疗可能与 eGFR 变化无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Effect of Entecavir, Tenofovir Disoproxil Fumarate, and Tenofovir Alafenamideantiviral Therapy on Renal Function in Chronic Hepatitis B Patients: A Real-World Retrospective Study.

Background: Entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide(TAF) are first-line nucleos(t)ide analogs (NUCs) with chronic hepatitis B (CHB). This study aimed to assess the renal safety profile in NUC-experienced CHB patients who received ETV, TDF or TAF therapy.

Methods: This retrospective observational cohort study investigated factors related to renal function in 154 patients with NUC-experienced CHB who received ETV, TDF, and TAF therapy for 48 weeks. Changes in UREA, uric acid (UA), creatinine (Cr), and estimated glomerular filtration rate (eGFR) were analyzed using a one-way analysis of variance. A linear mixed-effects model for repeated measures was used to evaluate the correlation between baseline information and eGFR changes 48 weeks following treatment initiation. The model considered sex, baseline age, viral load, aminotransferases, renal function, and treatment group as fixed effects, and incorporated random effects for individual subjects.

Results: There were no significant differences in UA or Cr levels during therapy over time. The eGFR level was elevated in ETV-treated patients (117.5 ± 16.65 mL/min/1.7m² vs 109.8 ± 15.69 mL/min/1.7m², P=0.027), whereas it did not change significantly in TDF- (123.6 ± 28.54 mL/min/1.7m² vs 115.5 ± 20.44 mL/min/1.7m², P=0.070) and TAF-treated (121.6 ± 23.44 mL/min/1.7m² vs 113.4 ± 16.90 mL/min/1.7m², P=0.053) patients. Younger patients (<30 years) and those with higher HBV DNA (> 7 log₁₀IU/mL) and lower alanine aminotransferase levels (<5 × upper limit of normal) showed a significant improvement in eGFR elevation during NUCs therapy. The linear mixed-effects model showed that the baseline HBV DNA level was an important positive predictor of eGFR elevation at 48 weeks following treatment initiation (estimate was 1.437 and 2.449, P<0.001).

Conclusion: In real-life experience, ETV, TDF, and TAF therapy may not be associated with eGFR changes in NUC-experienced CHB patients without baseline renal impairment.

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来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.