The effects of tenofovir disoproxil fumarate, tenofovir alafenamid and entecavir on renal functions used in the treatment of chronic hepatitis B

Introduction and Aim: Chronic Hepatitis B has infected more than 250 million people in the world and is still one of the most common causes among the etiology of hepatocellular carcinoma. Although tenofovir disoproxil fumarate, tenofovir alafenamide and entecavir are currently used in the treatment, there is no clear opinion regarding the renal toxicities of these drugs. In our study, the renal toxicity of these agents was investigated. Materials and Methods: Our study was carried out retrospectively and in a single center with patients with chronic hepatitis B who applied to Manisa Celal Bayar University Faculty of Medicine Gastroenterology Clinic between 01.01.2017-31.12.2022. Demographic and laboratory data of the cases were compared. Results: Of the 189 patients included in the study, 58.7% were male, 41.3% were female, and the mean age was 55.06±12.61 years. When compared with the pre-treatment period, urea levels increased significantly in the patients who received ETV and TDF treatment in the 2nd year of treatment; It was observed that there was no significant difference in the cases who received TAF treatment. When the creatinine and GFR levels of the cases were compared with the pre-treatment period in the cases who received both ETV, TAF and TDF treatment, it was determined that there was no significant difference in the 2nd year of the treatment. In our study, it was observed that there was a significant decrease in HBVDNA in the 1st month of both ETV, TAF and TDF treatment; When the viral response levels in the 2nd year of treatment were examined, it was seen that it was not at a good level (HBVDNA >120 copies/mL) in both ETV, TAF and TDF cases. In our results, no significant difference was found in patients who received both ETV, TAF and TDF treatment in terms of phosphate, INR and total bilirubin levels. Discussion and Conclusion: In our study, it was found that the urea levels of the cases increased in the cases who received ETV and TDF treatment in the 2nd year of treatment; It was observed that there was no variability in the treatment of TAF. Other kidney and liver function tests did not change with treatment. Although it showed that the viral response of the treatments received decreased compared to the pre-treatment, the HBVDNA copy number in the 2nd year of the treatment was not at a good level. Larger number of patients and multicenter studies are needed to generalize our results.