Efficacy and safety of entecavir for hepatitis B virus-associated glomerulonephritis with renal insufficiency.
Humans
Hepatitis B virus
Hepatitis B, Chronic
/ complications
Retrospective Studies
Creatinine
Angiotensin Receptor Antagonists
/ therapeutic use
Angiotensin-Converting Enzyme Inhibitors
/ therapeutic use
Antiviral Agents
/ adverse effects
Glomerulonephritis
/ diagnosis
Renal Insufficiency
/ chemically induced
Treatment Outcome
Antiviral drug
Entecavir
Glomerulonephritis
Hepatitis B virus
Renal insufficiency
Journal
Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
17
09
2022
accepted:
13
04
2023
medline:
19
7
2023
pubmed:
28
4
2023
entrez:
28
4
2023
Statut:
ppublish
Résumé
HBV-GN is one of the most common secondary kidney diseases in China. Entecavir is a first-line antiviral therapy in patients with HBV-GN. This retrospective study explored whether entecavir is effective and safe for the treatment of HBV-GN with renal insufficiency. We screened patients diagnosed with HBV-GN in The Affiliated Hospital of Qingdao University who had elevated serum creatinine levels. Group 1 (30 patients) was given entecavir as antiviral treatment. Group 2 (28 patients) was treated with ARBs. Changes in renal function and the possible influencing factors were observed, with a mean follow-up duration of 36 months. At the end of follow-up, the elevation in the serum creatinine level and reduction in the eGFR were greater in group 1 than in group 2. The overall renal survival rate, using eGFR < 15 ml/min as the primary renal end point, was 96.7% in group 1 and 67.9% in group 2. Urine protein excretion was decreased in both groups. Treatment with entecavir and the remission of proteinuria were protective factors against renal function impairment, while a lower baseline eGFR was a risk factor for progression to ESRD. Entecavir slows the progression of renal function impairment in HBV-GN and exerts a significant renal protective effect.
Sections du résumé
BACKGROUND
BACKGROUND
HBV-GN is one of the most common secondary kidney diseases in China. Entecavir is a first-line antiviral therapy in patients with HBV-GN.
OBJECTIVE
OBJECTIVE
This retrospective study explored whether entecavir is effective and safe for the treatment of HBV-GN with renal insufficiency.
METHODS
METHODS
We screened patients diagnosed with HBV-GN in The Affiliated Hospital of Qingdao University who had elevated serum creatinine levels. Group 1 (30 patients) was given entecavir as antiviral treatment. Group 2 (28 patients) was treated with ARBs. Changes in renal function and the possible influencing factors were observed, with a mean follow-up duration of 36 months.
RESULTS
RESULTS
At the end of follow-up, the elevation in the serum creatinine level and reduction in the eGFR were greater in group 1 than in group 2. The overall renal survival rate, using eGFR < 15 ml/min as the primary renal end point, was 96.7% in group 1 and 67.9% in group 2. Urine protein excretion was decreased in both groups. Treatment with entecavir and the remission of proteinuria were protective factors against renal function impairment, while a lower baseline eGFR was a risk factor for progression to ESRD.
CONCLUSIONS
CONCLUSIONS
Entecavir slows the progression of renal function impairment in HBV-GN and exerts a significant renal protective effect.
Identifiants
pubmed: 37115381
doi: 10.1007/s10157-023-02351-z
pii: 10.1007/s10157-023-02351-z
doi:
Substances chimiques
entecavir
5968Y6H45M
Creatinine
AYI8EX34EU
Angiotensin Receptor Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
680-686Subventions
Organisme : National Natural Science Foundation of China
ID : 81870494
Informations de copyright
© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.
Références
Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol. 2018;3:383–403.
doi: 10.1016/S2468-1253(18)30056-6
Dong H, Xu Y, Xu T, Sun JY, Bu QD, Wang YF, et al. The role of HBx gene mutations in PLA (2)R positive hepatitis-B-associated membranous nephropathy. Biomed Environ Sci. 2020;33:269–72.
pubmed: 32438964
Liu A, Le A, Zhang J, Wong C, Wong C, Henry L, et al. Increasing co-morbidities in chronic hepatitis B patients: experience in primary care and referral practices during 2000–2015. Clin Transl Gastroenterol. 2018;9:141.
doi: 10.1038/s41424-018-0007-6
pubmed: 29540676
pmcid: 5862154
Shah AS, Amarapurkar DN. Spectrum of hepatitis B and renal involvement. Liver Int. 2018;38:23–32.
doi: 10.1111/liv.13498
pubmed: 28627094
European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67:370–98.
doi: 10.1016/j.jhep.2017.03.021
Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67:1560–99.
doi: 10.1002/hep.29800
pubmed: 29405329
Yan YP, Su HX, Ji ZH, Shao ZJ, Pu ZS. Epidemiology of hepatitis B virus infection in China: current status and challenges. J Clin Transl Hepatol. 2014;2:15–22.
pubmed: 26356070
pmcid: 4521251
Zhang L, Wang F, Wang L, Wang W, Liu B, Liu J, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet. 2012;379:815–22.
doi: 10.1016/S0140-6736(12)60033-6
pubmed: 22386035
Kim SE, Jang ES, Ki M, Gwak GY, Kim KA, Kim GA, et al. Chronic hepatitis B infection is significantly associated with chronic kidney disease: a population-based, matched case-control study. J Korean Med Sci. 2018;33:e264.
doi: 10.3346/jkms.2018.33.e264
pubmed: 30310365
pmcid: 6179986
Fabrizi F, Cerutti R, Ridruejo E. Hepatitis B virus infection as a risk factor for chronic kidney disease. Expert Rev Clin Pharmacol. 2019;12:867–74.
doi: 10.1080/17512433.2019.1657828
pubmed: 31456441
Liu J, Liang W, Jing W, Liu M. Countdown to 2030: eliminating hepatitis B disease. China Bull World Health Organ. 2019;97:230–8.
doi: 10.2471/BLT.18.219469
pubmed: 30992636
Amet S, Bronowicki JP, Thabut D, Zoulim F, Bourliere M, Mathurin P, et al. Prevalence of renal abnormalities in chronic HBV infection: the HARPE study. Liver Int. 2015;35:148–55.
doi: 10.1111/liv.12480
pubmed: 24502506
Si J, Yu C, Guo Y, Bian Z, Qin C, Yang L, et al. Chronic hepatitis B virus infection and risk of chronic kidney disease: a population-based prospective cohort study of 0.5 million Chinese adults. BMC Med. 2018;16:93.
doi: 10.1186/s12916-018-1084-9
pubmed: 29909773
pmcid: 6004660
Ning L, Lin W, Hu X, Fan R, Liang X, Wu Y, et al. Prevalence of chronic kidney disease in patients with chronic hepatitis B: a cross-sectional survey. J Viral Hepat. 2017;24:1043–51.
doi: 10.1111/jvh.12733
pubmed: 28581186
Fabrizi F, Messa P, Basile C, Martin P. Hepatic disorders in chronic kidney disease. Nat Rev Nephrol. 2010;6:395–403.
doi: 10.1038/nrneph.2010.37
pubmed: 20386560
Gupta A, Quigg RJ. Glomerular diseases associated with hepatitis B and C. Adv Chronic Kidney Dis. 2015;22:343–551.
doi: 10.1053/j.ackd.2015.06.003
pubmed: 26311595
Chinese Society of Infectious Diseases and Chinese Society of Hepatology. The guideline of prevention and treatment for chronic hepatitis B (2019 version). Chin J Clin Infect Dis. 2019;12:401–128.
Fujii T, Kawasoe K, Ohta A, Nitta K. A case of entecavir-induced Fanconi syndrome. CEN Case Rep. 2019;8:256–60.
doi: 10.1007/s13730-019-00404-5
pubmed: 31154657
pmcid: 6820641
Suzuki K, Suda G, Yamamoto Y, Furuya K, Baba M, Kimura M, et al. Entecavir treatment of hepatitis B virus-infected patients with severe renal impairment and those on hemodialysis. Hepatol Res. 2019;49:1294–304.
doi: 10.1111/hepr.13399
pubmed: 31260579
Tsai MC, Chen CH, Tseng PL, Hung CH, Chiu KW, Wang JH, et al. Comparison of renal safety and efficacy of telbivudine, entecavir and tenofovir treatment in chronic hepatitis B patients: real world experience. Clin Microbiol Infect. 2016;22:95.e1-e7.
doi: 10.1016/j.cmi.2015.05.035
pubmed: 26055419
Jiang W, Liu T, Dong H, Xu Y, Liu LQ, Guan GJ, et al. Relationship between serum DNA replication, clinicopathological characteristics and prognosis of hepatitis B virus-associated glomerulonephritis with severe proteinuria by lamivudine plus adefovir dipivoxil combination therapy. Biomed Environ Sci. 2015;28:206–13.
pubmed: 25800445