Research of effectivenes of tenofovir used in treatment of chronic hepatitis b infection on bone mineralization

Two billion individuals worldwide have exposed to hepatitis B virus (HBV) and 350 millions of them are chronically infected with HBV. Infection experienced in newborn period and during the first one year of life becomes chronic in the ratio of 90%, this ratio reduces to 30% between 1-5 years. Risk of chronicity is about 2-5%in adult age. Main routes for HBV transmission are vertical transmission, parenteral transmission, horizontal transmission, unprotected sexual intercourse and nosocomial transmission caused by medical procedures. Pegylated-interferons with immunomodulatory and antiviral effects and oral antiviral agents are used today for treatment of chronic hepatitis B. Oral antiviral agent tenofovir: Inhibits HBV polymerase activity, DNA chain terminates after introduced into the DNA. In HIV patients, a reduction in bone mineral density was determined under the treatment of tenofovir. In this study; it was aimed to investigate the effect on bone mineralization with tenofovir in chronic HBV infection patients. Thirty patients who were admitted to Clinical Microbiology and Infectious Diseases Clinic of Fırat University Hospital and who was started tenofovir treatment admitted to this study. Patients Lumbar spine were performed with DEXA measurements before the treatment and the 1st, 2nd and 3rd year of the treatment. The decrease in bone mineral density was found to be statistically significant in T and Z scores which was measured initiation and 3rd year of treatment. A significant relationship was found between Vitamin D and reduction in the bone mineralization. As a result; There was a decrease in bone mineral density in patients who was chronic hepatit b and who was treated with tenofovir (p<0.05). Because of these side effects, HBV infected patients who were treated with tenofovir should be followed periodically and vitamin D supplementation should be done who was needed. Keywords: Chronic hepatitis B, Tenofovir, bone mineralization, vitamin D