Comparison of Renal Function Between Tenofovir Disoproxil Fumarate and Other Nucleos(t)ide Reverse Transcriptase Inhibitors in Patients With Hepatitis B Virus Infection

Matthew G Fischer; William Newman; Kimberly Hammer; Melissa Rohrich; Tze Shien Lo

doi:10.12788/fp.0169

Comparison of Renal Function Between Tenofovir Disoproxil Fumarate and Other Nucleos(t)ide Reverse Transcriptase Inhibitors in Patients With Hepatitis B Virus Infection

Fed Pract. 2021 Aug;38(8):363-367. doi: 10.12788/fp.0169.

Authors

Matthew G Fischer¹, William Newman¹, Kimberly Hammer¹, Melissa Rohrich¹, Tze Shien Lo¹

Affiliation

¹ At the time of the study, was Chief of Endocrinology and was a Pharmacy Resident; is Associate Chief of Staff/Research and Development; is Chief of Pharmacy; is Chief of Infectious Disease; all at Fargo Veterans Affairs Health Care System in North Dakota. Kimberly Hammer is Associate Professor, Internal Medicine Department, University of North Dakota School of Medicine and Health Sciences. Matthew Fischer is a Clinical Pharmacy Practitioner at Veterans Affairs Northern California Health Care System in Mather.

Abstract

Background: Nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) have become a standard treatment for both HIV and hepatitis B virus (HBV) infections. Tenofovir disoproxil fumarate (TDF) has been associated with kidney injury and possible long-term damage in patients with HIV. Few studies have examined whether this holds true for patients treated for HBV.

Methods: Data were gathered from the Veterans Health Administration Corporate Data Warehouse between July 1, 2005 and July 31, 2015. Patients aged ≥ 18 years with HBV infection and prescribed a NRTI for > 1 month were included in the study and followed for 36 months. Patients with HIV infection were excluded, and patients treated with combination TDF/emtricitabine were analyzed separately from patients receiving only TDF. A linear mixed model was used to examine the effects of time and specific agent on renal function, which was measured with estimated glomerular filtration rate (eGFR) at various time intervals.

Results: There were 413 incidences of NRTI use in 308 subjects during the 10 years of the study with 39 cases of TDF use. There was a significant fixed effect of time, with eGFR reduction of 4.6 mL/min (P < .001) over the course of the study for the full cohort, but the effects of each medication were not significant.

Conclusions: This multicenter, retrospective study did not demonstrate an association between TDF use and a greater degree of kidney injury compared with other NRTIs in patients with HBV, but further studies are warranted.