Abstract: SA-PO495

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

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

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