Kidney Week

Abstract: SA-PO495

Comparison of Renal Safety and Efficacy of Tenofovir and Entecavir Treatment in Chronic Hepatitis B Patients with Kidney Transplantation

Session Information

• Transplantation: Balancing Rejection and Infection
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Kim, Seonghoon, Asan Medical Center, University of Ulsan College of Medicine, SEOUL, Korea (the Republic of)

Seonghoon Kim,

• Kim, Hyosang, Asan Medical Center, University of Ulsan College of Medicine, SEOUL, Korea (the Republic of)

Hyosang Kim,

• Bae, Soo Ya, Asan Medical Center, University of Ulsan College of Medicine, SEOUL, Korea (the Republic of)

Soo Ya Bae,

Background

Nucleotide reverse transcriptase inhibitor is used for the treatment of chronic hepatitis B (CHB). Preemptive antiviral therapy can improve the survival of HBsAg-positive renal allograft recipients. But there are concerns about the potential risk of nephrotoxicity with long-term use. This study aims to assess the nephrotoxicity and efficacy of tenofovir and entecavir in kidney transplant recipients.

Methods

We performed a single center based, retrospective study of 55 patients with CHB treated with tenofovir (n=34) and entecavir (n=21) after kidney transplantation. Patients with a decrease <20% in eGFR were recorded, calculated using the Modification of Diet in Renal Disease. Treatment efficacy was assessed by HBV DNA levels and virological breakthrough.

Results

Tenofovir was associated with a decrease in eGFR at 1 year from treatment (unadjusted odds ratio, 10.313; 95% CI, 1.111-95.762; p=0.026; patients with decreased GFR, 5/21 vs. 1/34). Mean eGFR at 1 year was 55.6 ml/min/1.73m² and 64.0 ml/min/1.73m² at tenofovir and entecavir group. Delta eGFR at 1 year was -2.82 ml/min/1.73m² in entecavir group and 0.10 ml/min/1.73m² in tenofovir group. There was no significant change in eGFR between the entecavir group and the tenofovir group after a mean of 45 months (Mean eGFR, 56.5 ml/min/1.73m² vs. 62.7 ml/min/1.73m²). There was no difference in rate of virological breakthrough between two groups at the end of treatment (patients with virological breakthrough, 5/21 vs. 6/34; p=0.731). By multivariate analysis, the significant factor associated with a decrease in eGFR at 1 year from treatment were tenofovir (adjusted odds ratio, 18.477; 95% CI, 1.123-275.953; p=0.034).

Conclusion

Patients who received KT and treated with tenofovir were likely to have decline in renal function than patients who treated with entecavir at 1 year from treatment. Tenofovir was independently associated with decrease in eGFR at 1 year from treatment. There was no significant difference in an efficacy between tenofovir and entecavir group at the end of treatment.