Publication: Nephrotoxicity caused by oral antiviral agents in patients with chronic hepatitis B treated in a hospital for tropical diseases in Thailand
Issued Date
2015
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Pharmacology and Toxicology. Vol.16, (2015), 38
Suggested Citation
Thu, Aung Myint, Kittiyod Poovorawan, Chatporn Kittitrakul, Apichart Nontprasert, Natthida Sriboonvorakul, Weerapong Phumratanaprapin, Pisit Tangkijvanich, Wattana Leowattana, Polrat Wilairatana Nephrotoxicity caused by oral antiviral agents in patients with chronic hepatitis B treated in a hospital for tropical diseases in Thailand. BMC Pharmacology and Toxicology. Vol.16, (2015), 38. doi:10.1186/s40360-015-0037-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3077
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Title
Nephrotoxicity caused by oral antiviral agents in patients with chronic hepatitis B treated in a hospital for tropical diseases in Thailand
Abstract
Background: There is increasing concern about the potential for nephrotoxicity in patients with chronic hepatitis B
(CHB) treated long-term with nucleotide analogs.
Methods: We examined renal dysfunction and its associated risk factors in patients with CHB treated with antiviral
regimens containing either nucleosides or nucleotide analogs. We undertook a retrospective cohort study from
2006 to 2014 at the Hospital for Tropical Diseases, Bangkok, Thailand, and analyzed the data of 102 patients with a
median follow-up time of 44.5 months (range 4–101 months).
Results: Seventy-three patients were treated with an antiviral regime containing a nucleoside analog, and 29 with
a regime containing a nucleotide analog. Abnormally elevated serum creatinine concentration was observed in
12 patients (11.8 %) after 8 years of treatment. Thirty one percent of patients treated with nucleotide analogs had
elevated serum creatinine levels and three of these patients (10.3 %) developed nephrotoxicity. In contrast,
serum creatinine concentrations were elevated in three of the 73 patients treated with a nucleoside analog
(4.1 %), and none developed nephrotoxicity. The incidence of renal dysfunction by the nucleotide analog
regimen was cumulative, with 11.1, 21.0, 26.5 and 47.6 % of patients affected after 2, 4, 6 and 8 years, respectively.
Univariate and multivariate analysis indicated that a nucleotide analog-based regimen significantly predicted renal
dysfunction (odds ratio 10.5, 95 % confidence intervals 2.6–42.4, P <0.001).
Conclusion: The long-term use of nucleotide analogs increased the risk of nephrotoxicity in patients with CHB. Thus,
the regular assessment of renal function is recommended for all patients with CHB, particularly those treated with a
nucleotide analog.