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Treatment and Renal Outcomes Up to 96 Weeks After Tenofovir Alafenamide Switch From Tenofovir Disoproxil Fumarate in Routine Practice
Author(s) -
Toyoda Hidenori,
Leong Jennifer,
Landis Charles,
Atsukawa Masanori,
Watanabe Tsunamasa,
Huang Daniel Q.,
Liu Joanne,
Quek Sabrina Xin Zi,
Ishikawa Toru,
Arai Taeang,
Yokohama Keisuke,
Chuma Makoto,
Takaguchi Koichi,
Uojima Haruki,
Senoo Tomonori,
Dang Hansen,
Maeda Mayumi,
Hoang Joseph,
Le Richard H.,
Yasuda Satoshi,
Thin Khin N.,
Tran Sally,
Chien Nicholas,
Henry Linda,
Asai Akira,
Fukunishi Shinya,
Cheung Ramsey,
Lim Seng Gee,
Trinh Huy N.,
Nguyen Mindie H.
Publication year - 2021
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.31793
Subject(s) - tenofovir alafenamide , medicine , renal function , kidney disease , creatinine , population , gastroenterology , stage (stratigraphy) , tenofovir , urology , cobicistat , viral load , immunology , virus , biology , paleontology , environmental health , human immunodeficiency virus (hiv) , antiretroviral therapy
Background and Aims Real‐world data for treatment effectiveness and renal outcomes in chronic hepatitis B (CHB) patients who were switched to the new and safer prodrug tenofovir alafenamide (TAF) from tenofovir disoproxil fumarate (TDF) are limited. Therefore, we aimed to evaluate treatment and renal outcomes of this population. Approach and Results We analyzed 834 patients with CHB previously treated with TDF for ≥12 months who were switched to TAF in routine practice at 13 US and Asian centers for changes in viral (HBV DNA < 20 IU/mL), biochemical (alanine aminotransferase [ALT] < 35/25 U/L for male/female), and complete (viral+biochemical) responses, as well as estimated glomerular filtration rate (eGFR; milliliters per minute per 1.73 square meters) up to 96 weeks after switch. Viral suppression ( P < 0.001) and ALT normalization ( P = 0.003) rates increased significantly after switch, with a trend for increasing complete response ( P trend = 0.004), while the eGFR trend ( P trend > 0.44) or mean eGFR ( P > 0.83, adjusted for age, sex, baseline eGFR, and diabetes, hypertension, or cirrhosis by generalized linear modeling) remained stable. However, among those with baseline eGFR < 90 (chronic kidney disease [CKD] stage ≥2), mean eGFR decreased significantly while on TDF ( P = 0.029) but not after TAF switch ( P = 0.90). By week 96, 21% (55/267) of patients with CKD stage 2 at switch improved to stage 1 and 35% (30/85) of CKD stage 3‐5 patients improved to stage 2 and 1.2% (1/85) to stage 1. Conclusions Overall, we observed continued improvement in virologic response, ALT normalization, and no significant changes in eGFR following switch to TAF from TDF.