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Entecavir treatment of hepatitis B virus‐infected patients with severe renal impairment and those on hemodialysis
Author(s) -
Suzuki Kazuharu,
Suda Goki,
Yamamoto Yoshiya,
Furuya Ken,
Baba Masaru,
Kimura Megumi,
Maehara Osamu,
Shimazaki Tomoe,
Yamamoto Koji,
Shigesawa Taku,
Nakamura Akihisa,
Ohara Masatsugu,
Kawagishi Naoki,
Nakai Masato,
Sho Takuya,
Natsuizaka Mitsuteru,
Morikawa Kenichi,
Ogawa Koji,
Sakamoto Naoya
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13399
Subject(s) - entecavir , medicine , renal function , hemodialysis , gastroenterology , alanine transaminase , tenofovir alafenamide , hepatitis b virus , kidney disease , hepatitis b , creatinine , lamivudine , virology , viral load , virus , antiretroviral therapy
Aim Entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) are first‐line nucleos(t)ide analogues for hepatitis B virus (HBV)‐infected patients. However, consecutive TDF treatment causes renal dysfunction, and the safety and efficacy of TAF have not been established in severe renal dysfunction patients, including hemodialysis patients. The efficacy and safety of ETV in these populations has not been clarified. The study aimed to clarify this. Methods In this retrospective multicenter study, between 2006 and 2018, a total of 567 HBV‐infected patients treated with ETV monotherapy were screened. Patients were included if >20 years old, treated with ETV monotherapy for >1 year, and had proper clinical information. The efficacy of ETV and changes in renal function were evaluated according to renal function. Results A total of 273 patients were included: 9.2% (25/273), 1.8% (5/273), and 3.7% (10/273) had chronic kidney disease (CKD) stage G3, CKD stage G4/5, and were on hemodialysis, respectively. Overall, 84.2%, 94.0%, and 96.2% of patients experienced serum HBV‐DNA disappearance at 1, 2, and 3 years, respectively, after treatment initiation. In patients with CKD stage G3–5, estimated glomerular filtration rate tended to restore with time, which was in contrast to patients without renal dysfunction. The rate of disappearance in serum HBV‐DNA, alanine transaminase normalization, and virological breakthrough was similar between patients with or without renal dysfunction. ETV showed high efficacy for all 10 hemodialysis patients without virological breakthrough. Conclusions Entecavir for HBV‐infected patients with severe renal dysfunction, including hemodialysis patients, is highly effective and does not affect renal function.