Effects of entecavir and tenofovir alafenamide fumarate treatment on renal function in Japanese elderly patients with chronic hepatitis B.

Abstract

Entecavir (ETV) and tenofovir alafenamide fumarate (TAF) are considered safe nucleoside/nucleotide analogs (NA) for the kidney. This study aimed to investigate the long-term effects of ETV or TAF on renal function in elderly patients with chronic hepatitis B (CHB) in Japan. The study included 246 CHB patients treated with ETV (184 patients) or TAF (62 patients) for at least 2years. These patients were divided into two groups: those <65years of age (130 patients) and those ≥65years of age (116 patients). The effects of the NAs on renal functions were examined by comparing the estimated glomerular filtration rates (eGFR) from baseline to 2years between the two groups. The change in eGFR from baseline to 1 or 2years after treatment was significantly decreased in both groups. However, the amount of change at 1 and 2years was significantly greater in the group aged ≥65years than in the group aged <65years. The amount of change in eGFR from baseline to 1 and 2years after treatment was significantly greater in the group aged ≥65years than in the group aged <65years, regardless of the type of NA, the prior treatment history, cirrhosis/chronic hepatitis, hypertension, dyslipidemia, and diabetes. Additionally, logistic regression analysis showed that age ≥65years was independently associated with a decreased eGFR after 2years of NA treatment. Long-term administration of NA to CHB patients over 65years of age should be carefully monitored for renal impairment.