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Updated: Oct 14, 2025

Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors
Published on: May 9, 2025
Comparison of Renal Function Between Tenofovir Disoproxil Fumarate and Other Nucleos(t)ide Reverse Transcriptase
Matthew G Fischer1, William Newman1, Kimberly Hammer1
1At the time of the study, was Chief of Endocrinology and was a Pharmacy Resident; is Associate Chief of Staff/Research and Development; is Chief of Pharmacy; is Chief of Infectious Disease; all at Fargo Veterans Affairs Health Care System in North Dakota. Kimberly Hammer is Associate Professor, Internal Medicine Department, University of North Dakota School of Medicine and Health Sciences. Matthew Fischer is a Clinical Pharmacy Practitioner at Veterans Affairs Northern California Health Care System in Mather.
Tenofofovir disoproxil fumarate (TDF) did not show a greater association with kidney injury compared to other nucleoside reverse transcriptase inhibitors (NRTIs) in patients with hepatitis B virus (HBV). Further research is needed to confirm these findings in HBV patients.
Area of Science:
- Hepatitis B Virus (HBV) infection management
- Antiviral therapy
- Nephrology
Background:
- Nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) are standard treatments for HIV and HBV.
- Tenofofovir disoproxil fumarate (TDF) is associated with kidney injury in HIV patients.
- Limited data exist on TDF's renal effects in HBV patients.
Purpose of the Study:
- To investigate the association between tenofofovir disoproxil fumarate (TDF) use and kidney injury in patients with hepatitis B virus (HBV) infection.
- To compare the renal effects of TDF with other NRTIs in an HBV cohort.
Main Methods:
- Retrospective analysis of Veterans Health Administration data (2005-2015).
- Included patients aged ≥18 with HBV, treated with NRTIs for >1 month, excluding HIV patients.
- Assessed renal function using estimated glomerular filtration rate (eGFR) over 36 months via linear mixed models.
Main Results:
- 413 NRTI uses in 308 subjects; 39 cases of TDF use.
- Overall cohort showed a significant time-dependent eGFR reduction of 4.6 mL/min (P < .001).
- No significant effect of specific NRTI agents on eGFR was found.
Conclusions:
- This study did not demonstrate a greater association between TDF use and kidney injury compared to other NRTIs in HBV patients.
- Further research is warranted to confirm these findings and understand long-term renal outcomes in HBV patients treated with TDF.
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