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A low dose of tenofovir disoproxil fumarate (TDF) may help to preserve renal function and maintain viral suppression in patients with chronic hepatitis B virus infection, even those with advanced liver disease, according to new research.
TDF (Viread, Gilead) is currently approved for the treatment of chronic hepatitis B virus infection in adults and pediatric patients who are 12 years and older. Although the treatment is effective in inhibiting hepatitis B virus replication, it can cause renal impairment. To this end, investigators led by Dr. Kin Seng Liem from the Toronto Centre for Liver Disease and the University Health Network in Toronto, Ontario, Canada, studied renal function and viral breakthrough in a group of 739 patients from a North American hospital who were renally-impaired and treated with TDF. The investigators compared outcomes for those patients on a reduced dose of TDF (due to GFR [Cockcroft-Gault] <50mL/min/1.73m2 ± serum phosphate <0.8mmol/L) with outcomes for patients on a full dose.
The study investigators concluded that a lower dose of TDF could be used in patients with chronic hepatitis B virus infection who are renally-impaired, particularly those who are in resource-limited settings.
The study, “Low Dose Tenofovir Disoproxil Fumarate Improves Kidney Function and Sustains Virologic Suppression in Renally Compromised Chronic Hepatitis B Patients,” was presented at the 2018 American Association for the Study of Liver Diseases (AASLD) Liver Meeting, November 9-13, 2018, in San Francisco, California.