Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective study
Background: Tenofovir disoproxil fumarate (TDF) as first-line therapy for chronic HBV infection is related to nephrotoxicity. Tenofovir alafenamide fumarate (TAF) has been approved with a similar virological and serological response, but lower toxicity. TAF is available for older patients, with bone...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Journal of Clinical Virology Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667038023000418 |
| _version_ | 1797324313122045952 |
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| author | Giacomo Stroffolini Valentina Dodaro Amedeo De Nicolò Jessica Cusato Giovanni Di Perri Antonio D'Avolio Lucio Boglione |
| author_facet | Giacomo Stroffolini Valentina Dodaro Amedeo De Nicolò Jessica Cusato Giovanni Di Perri Antonio D'Avolio Lucio Boglione |
| author_sort | Giacomo Stroffolini |
| collection | DOAJ |
| description | Background: Tenofovir disoproxil fumarate (TDF) as first-line therapy for chronic HBV infection is related to nephrotoxicity. Tenofovir alafenamide fumarate (TAF) has been approved with a similar virological and serological response, but lower toxicity. TAF is available for older patients, with bone or kidney impairment. Methods: The primary objective was the evaluation of renal function modification in patients who are switching from TDF to TAF; secondary objective was the use of urinary concentration of tenofovir (TFV) as early marker of renal function improvement or worsening.Retrospective study including all HBV patients treated with TDF or TAF. Two groups were selected: patients who are switched from TDF to TAF and who continued with TDF. Follow-up was six months. Results: 42 subjects were included; 17 were in TAF group (40 %) and 25 in TDF group (60 %). In TDF group, no estimated glomerular filtration rate (eGFR) improvement was observed, while in TAF group increased by 9 ml/min (p < 0.001). Urinary TFV levels increased by 3 ng/mL in TDF group and decreased by 4.5 ng/mL in TAF group (p < 0.001). The relationship between the eGFR and urinary TFV resulted in reverse proportionality (R2 = -0.740, p = 0.001) between the two variables. In multivariate analysis eGFR (β = 0.880, p = 0.043) and pretreatment wit adefovir dipivoxil (ADV) resulted significantly related to TFV urinary excretion. Conclusions: Switching from TDF to TAF lead to significant improvement in eGFR and lower toxicity (estimated with TFV urinary excretion) at six months of follow-up. ADV pretreatment should be considered as adjunctive risk factor for nephrotoxicity independently from age and eGFR. |
| first_indexed | 2024-03-08T05:54:15Z |
| format | Article |
| id | doaj.art-14c0c57ef3724c2a94db2e9a470c149a |
| institution | Directory Open Access Journal |
| issn | 2667-0380 |
| language | English |
| last_indexed | 2024-03-08T05:54:15Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Virology Plus |
| spelling | doaj.art-14c0c57ef3724c2a94db2e9a470c149a2024-02-05T04:32:24ZengElsevierJournal of Clinical Virology Plus2667-03802024-02-0141100174Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective studyGiacomo Stroffolini0Valentina Dodaro1Amedeo De Nicolò2Jessica Cusato3Giovanni Di Perri4Antonio D'Avolio5Lucio Boglione6Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, ItalyDepartment of Medical Sciences, Infectious Diseases, University of Turin, Turin, ItalyDepartment of Medical Sciences, Infectious Diseases, University of Turin, Turin, ItalyDepartment of Medical Sciences, Infectious Diseases, University of Turin, Turin, ItalyDepartment of Medical Sciences, Infectious Diseases, University of Turin, Turin, ItalyDepartment of Medical Sciences, Infectious Diseases, University of Turin, Turin, ItalyDepartment of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy; Corresponding author.Background: Tenofovir disoproxil fumarate (TDF) as first-line therapy for chronic HBV infection is related to nephrotoxicity. Tenofovir alafenamide fumarate (TAF) has been approved with a similar virological and serological response, but lower toxicity. TAF is available for older patients, with bone or kidney impairment. Methods: The primary objective was the evaluation of renal function modification in patients who are switching from TDF to TAF; secondary objective was the use of urinary concentration of tenofovir (TFV) as early marker of renal function improvement or worsening.Retrospective study including all HBV patients treated with TDF or TAF. Two groups were selected: patients who are switched from TDF to TAF and who continued with TDF. Follow-up was six months. Results: 42 subjects were included; 17 were in TAF group (40 %) and 25 in TDF group (60 %). In TDF group, no estimated glomerular filtration rate (eGFR) improvement was observed, while in TAF group increased by 9 ml/min (p < 0.001). Urinary TFV levels increased by 3 ng/mL in TDF group and decreased by 4.5 ng/mL in TAF group (p < 0.001). The relationship between the eGFR and urinary TFV resulted in reverse proportionality (R2 = -0.740, p = 0.001) between the two variables. In multivariate analysis eGFR (β = 0.880, p = 0.043) and pretreatment wit adefovir dipivoxil (ADV) resulted significantly related to TFV urinary excretion. Conclusions: Switching from TDF to TAF lead to significant improvement in eGFR and lower toxicity (estimated with TFV urinary excretion) at six months of follow-up. ADV pretreatment should be considered as adjunctive risk factor for nephrotoxicity independently from age and eGFR.http://www.sciencedirect.com/science/article/pii/S2667038023000418HBVTenofovir disoproxil fumarateTenofovir alafenamide fumarateNephrotoxicity |
| spellingShingle | Giacomo Stroffolini Valentina Dodaro Amedeo De Nicolò Jessica Cusato Giovanni Di Perri Antonio D'Avolio Lucio Boglione Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective study Journal of Clinical Virology Plus HBV Tenofovir disoproxil fumarate Tenofovir alafenamide fumarate Nephrotoxicity |
| title | Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective study |
| title_full | Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective study |
| title_fullStr | Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective study |
| title_full_unstemmed | Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective study |
| title_short | Switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with HBV infection: A retrospective study |
| title_sort | switching from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate in a cohort of patients with hbv infection a retrospective study |
| topic | HBV Tenofovir disoproxil fumarate Tenofovir alafenamide fumarate Nephrotoxicity |
| url | http://www.sciencedirect.com/science/article/pii/S2667038023000418 |
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