富马酸替诺福韦二吡呋酯与其他核苷（酸）类逆转录酶抑制

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富马酸替诺福韦二吡呋酯与其他核苷（酸）类逆转录酶抑制剂对乙型肝炎病毒感染患者肾功能的比较
马修 G 费舍尔 1 , 威廉纽曼 1 , 金伯利汉默 1 , 梅丽莎 Rohrich 1 , 慈世恩罗 1
隶属关系
联系

    1
    在研究期间，担任内分泌科主任和药房住院医师；是副参谋长/研发；是药剂科主任；是传染病科主任；全部在北达科他州的 Fargo 退伍军人事务医疗保健系统。 Kimberly Hammer 是北达科他大学医学与健康科学学院内科副教授。 Matthew Fischer 是位于马瑟的北加州退伍军人事务部医疗保健系统的临床药剂师。

    PMID：34733088 PMCID：PMC8560100 DOI：10.12788/fp.0169

抽象的

背景：核苷和核苷酸逆转录酶抑制剂 (NRTI) 已成为 HIV 和乙型肝炎病毒 (HBV) 感染的标准治疗方法。富马酸替诺福韦二吡呋酯 (TDF) 与 HIV 患者的肾损伤和可能的长期损伤有关。很少有研究检查这是否适用于接受 HBV 治疗的患者。

方法：数据收集自 2005 年 7 月 1 日至 2015 年 7 月 31 日期间退伍军人健康管理局企业数据仓库。 研究包括年龄≥18 岁的 HBV 感染患者和服用 NRTI 超过 1 个月的患者，并进行了 36 个月的随访。 . HIV 感染患者被排除在外，接受 TDF/恩曲他滨联合治疗的患者与仅接受 TDF 治疗的患者分开分析。线性混合模型用于检查时间和特定药物对肾功能的影响，肾功能通过不同时间间隔的估计肾小球滤过率 (eGFR) 进行测量。

结果：在 10 年的研究中，308 名受试者中有 413 次使用 NRTI，其中 39 例使用了 TDF。有一个显着的时间固定效应，在整个队列的研究过程中 eGFR 降低了 4.6 mL/min (P < .001)，但每种药物的影响并不显着。

结论：与其他 NRTIs 相比，这项多中心、回顾性研究并未证明 TDF 的使用与 HBV 患者的更大程度的肾损伤之间存在关联，但有必要进行进一步的研究。

版权所有 © 2021 Frontline Medical Communications Inc.，美国新泽西州帕西帕尼。

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Comparison of Renal Function Between Tenofovir Disoproxil Fumarate and Other Nucleos(t)ide Reverse Transcriptase Inhibitors in Patients With Hepatitis B Virus Infection
Matthew G Fischer  1 , William Newman  1 , Kimberly Hammer  1 , Melissa Rohrich  1 , Tze Shien Lo  1
Affiliations
Affiliation

    1
    At the time of the study, was Chief of Endocrinology and was a Pharmacy Resident; is Associate Chief of Staff/Research and Development; is Chief of Pharmacy; is Chief of Infectious Disease; all at Fargo Veterans Affairs Health Care System in North Dakota. Kimberly Hammer is Associate Professor, Internal Medicine Department, University of North Dakota School of Medicine and Health Sciences. Matthew Fischer is a Clinical Pharmacy Practitioner at Veterans Affairs Northern California Health Care System in Mather.

    PMID: 34733088 PMCID: PMC8560100 DOI: 10.12788/fp.0169

Abstract

Background: Nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) have become a standard treatment for both HIV and hepatitis B virus (HBV) infections. Tenofovir disoproxil fumarate (TDF) has been associated with kidney injury and possible long-term damage in patients with HIV. Few studies have examined whether this holds true for patients treated for HBV.

Methods: Data were gathered from the Veterans Health Administration Corporate Data Warehouse between July 1, 2005 and July 31, 2015. Patients aged ≥ 18 years with HBV infection and prescribed a NRTI for > 1 month were included in the study and followed for 36 months. Patients with HIV infection were excluded, and patients treated with combination TDF/emtricitabine were analyzed separately from patients receiving only TDF. A linear mixed model was used to examine the effects of time and specific agent on renal function, which was measured with estimated glomerular filtration rate (eGFR) at various time intervals.

Results: There were 413 incidences of NRTI use in 308 subjects during the 10 years of the study with 39 cases of TDF use. There was a significant fixed effect of time, with eGFR reduction of 4.6 mL/min (P < .001) over the course of the study for the full cohort, but the effects of each medication were not significant.

Conclusions: This multicenter, retrospective study did not demonstrate an association between TDF use and a greater degree of kidney injury compared with other NRTIs in patients with HBV, but further studies are warranted.

Copyright © 2021 Frontline Medical Communications Inc., Parsippany, NJ, USA.

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