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Long-term adefovir plus lamivudine therapy does not decrease creatinine clearance in HBeAg-negative chronic hepatitis
Spilios Manolakopoulos1, Athanasia Striki, Melanie Deutsch
12nd Academic Department of Internal Medicine, Hippokration Hospital of Athens, Athens, Greece. smanolak@med.uoa.gr
Long-term adefovir and lamivudine combination therapy did not independently cause significant renal dysfunction in patients with lamivudine-resistant hepatitis B. Age and baseline kidney function predict changes in renal function.
Area of Science:
- Hepatology
- Nephrology
- Virology
Background:
- Nucleotide analogues like adefovir and lamivudine are used for chronic hepatitis B.
- Concerns exist regarding potential kidney toxicity (nephrotoxicity) of these drugs.
Purpose of the Study:
- To evaluate renal function parameters in patients receiving long-term adefovir and lamivudine combination therapy.
- To determine if this combination therapy is an independent risk factor for nephrotoxicity.
Main Methods:
- Study included 46 HBeAg-negative patients with lamivudine-resistant hepatitis B.
- Patients received adefovir and lamivudine for up to 90 months.
- Renal function assessed by estimated creatinine clearance (eC(CR)) and compared to a control group.
Main Results:
- Hepatitis B virus (HBV) DNA became undetectable in 85% of treated patients.
- A significant decrease in mean eC(CR) was observed in treated patients (P=0.003).
- Similar eC(CR) changes occurred in the control group, indicating age and baseline eC(CR) were independent predictors of reduction.
Conclusions:
- Adefovir and lamivudine combination therapy is not an independent factor for significant renal dysfunction.
- Baseline age and creatinine clearance are the primary predictors of worsening renal function in this patient population.
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