Long-term adefovir plus lamivudine therapy does not decrease creatinine clearance in HBeAg-negative chronic hepatitis B patients
Article first published online: 11 AUG 2011
© 2011 John Wiley & Sons A/S
Volume 31, Issue 10, pages 1525–1532, November 2011
How to Cite
Manolakopoulos, S., Striki, A., Deutsch, M., Mela, M., Ketikoglou, I., Tzourmakliotis, D., Manesis, E. K. and Papatheodoridis, G. V. (2011), Long-term adefovir plus lamivudine therapy does not decrease creatinine clearance in HBeAg-negative chronic hepatitis B patients. Liver International, 31: 1525–1532. doi: 10.1111/j.1478-3231.2011.02616.x
- Issue published online: 10 OCT 2011
- Article first published online: 11 AUG 2011
- Manuscript Accepted: 8 JUL 2011
- Manuscript Received: 20 JAN 2011
- chronic hepatitis B;
- combination therapy;
- creatinine clearance;
- renal dysfunction
As there are concerns about potential nephrotoxicity of nucleotide analogues, we evaluated renal function parameters during long-term adefovir and lamivudine combination therapy.
Forty-six HBeAg-negative patients with lamivudine-resistance treated with adefovir and lamivudine for up to 90 months were included. Renal function was assessed by estimated creatinine clearance (eCCR) and compared with a matched control group of untreated inactive hepatitis B virus carriers.
Serum HBVDNA became undetectable in 39 (85%) patients after a mean of 37 ± 21 months. Three (6.5%) patients developed virological breakthrough. Adefovir resistance was detected in two patients. At the end of follow up, there was a significant decrease in mean eCCR (95 ± 31–83 ± 30 ml/min, P = 0.003) in the treated patients with 16% presenting aeCCR decrease >30%. Similar changes in eCCR were observed in the control group (108 ± 28–96 ± 26 ml/min, P = 0.003). In multiple regression analysis, age and baseline eCCR were independent predictors of eCCR reduction.
Adefovir and lamivudine combination therapy is not an independent factor for significant renal dysfunction in HBeAg-negative patients with lamivudine-resistance. Baseline age and creatinine clearance are the only independent predictors of worsening renal function.