Research of effect and side effect of antiviral therapy against hepatitis B in patients WHO are Kidney recipients

Introduction and Objective: Chronic kidney disease and HBV are an important factor for morbidity and mortality. Kidney recipients who has HBV have a risk of reactivation after exposure to immunosuppression. Reactivation of HBV may cause to greft dysfunction, loss of greft, liver dysfunction and loss of liver function. Therefore, patients who has HBV must take antiviral therapy. In our project, we aimed to inspect the impact of anti-HBV therapy on the results during the follow ups. Material and Method: In our project, 102 patients who had kidney transplantation between the year of 06.07.2001 and 09.02.2019 in Akdeniz University Faculty of Medicine Organ Transplantation Unit and that has taken anti- HBV therapy were searched retrospectively. In analysis, "p" value lower than 0.05 was defined mean full. Results: Patients median age was 47,5 years. 9 (8,8%) of patients were female 96 (91,2%) of patients were male. In our search, hypertension is found as most common cause of chronic kidney disease (16,6%). Those patients who take tenofovir disopoxil fumarat were found to have lower level and mean full declining rate of phosphorus than the other patients who take the other drugs. Tenofovir disoproxil fumarat was found to cause more raised creatinine level in a mean full rate than the other drugs. Tenofovir disoproxil fumarat was found to cause more decreased creatinine clirens levels in a mean full rate than the other drugs. Tenofovir disoproxil fumarat was found to cause higher and more raised proteinuria level in a mean full rate than the other drugs. During the follow ups, HBV DNA levels decreased more in a mean full rate in those patients who take entecavir and tenofovir alafenamide than the other patients who take other drugs. Conclusion: On kidney recipients that have HBV, choosing of antiviral therapy must based on high efficacy and high resistance barrier such as entecavir and tenofovir. Also, at choosing the treatment, renal side effects and suppressive effect on HBV DNA must be considered. Lamivudine is effective but has high rate of resistance and recent guidelines do not recommend lamivudine as a first line therapy. Key Words: Chronic kidney disease, Hepatitis B, reactivation, entecavir, tenofovir disoproxil fumarat