Hong-Yu Jia1, Feng Ding1, Jian-Yang Chen1, Jiang-Shan Lian1, Yi-Min Zhang1, Lin-Yan Zeng1, Dai-Rong Xiang1, Liang Yu1, Jian-Hua Hu1, Guo-Dong Yu1, Huan Cai1, Ying-Feng Lu1, Lin Zheng1, Lan-Juan Li1, Yi-Da Yang1. 1. Hong-Yu Jia, Feng Ding, Jian-Yang Chen, Jiang-Shan Lian, Yi-Min Zhang, Lin-Yan Zeng, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Guo-Dong Yu, Huan Cai, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
Abstract
AIM: To evaluate urine β2-microglobulin (β2-M), retinol-binding protein (RBP) excretion, and renal impairment with adefovir dipivoxil (ADV) for chronic hepatitis B. METHODS: We enrolled 165 patients with chronic hepatitis B infection who were treated with ADV monotherapy (n = 90) or ADV plus lamivudine combination therapy (n = 75). An additional 165 chronic hepatitis B patients treated with entecavir were recruited as controls. We detected serum creatinine, urine β2-M, and RBP levels, and estimated the glomerular filtration rate (eGFR) at the initiation of antiviral therapy and every 6 mo for a period of five years. RESULTS: Urine β2-M abnormalities were observed in patients during the first (n = 3), second (n = 7), third (n = 11), fourth (n = 16), and fifth (n = 21) year of ADV treatment. Urinary RBP abnormalities were observed in patients during the first (n = 2), second (n = 8), third (n = 12), fourth (n = 15), and fifth (n = 22) year of ADV treatment. eGFR decreased 20%-30% from baseline in 20 patients, 30%-50% in 12 patients, and > 50% in 3 patients during the five years of treatment. Further analysis indicated that decreases in eGFR of ≥ 30% relative to the baseline level correlated significantly with urine RBP and β2-M abnormalities. In contrast, both serum creatinine and eGFR remained stable in patients treated with entecavir, and only one of these patients developed a urine β2-M abnormality, and two developed urine RBP abnormalities during the five years of treatment. CONCLUSION: Urine RBP and β2-M are biomarkers of renal injury during long-term ADV treatment for chronic hepatitis B, and indicate when treatment should be switched to entecavir.
AIM: To evaluate urine β2-microglobulin (β2-M), retinol-binding protein (RBP) excretion, and renal impairment with adefovir dipivoxil (ADV) for chronic hepatitis B. METHODS: We enrolled 165 patients with chronic hepatitis B infection who were treated with ADV monotherapy (n = 90) or ADV plus lamivudine combination therapy (n = 75). An additional 165 chronic hepatitis Bpatients treated with entecavir were recruited as controls. We detected serum creatinine, urine β2-M, and RBP levels, and estimated the glomerular filtration rate (eGFR) at the initiation of antiviral therapy and every 6 mo for a period of five years. RESULTS: Urine β2-M abnormalities were observed in patients during the first (n = 3), second (n = 7), third (n = 11), fourth (n = 16), and fifth (n = 21) year of ADV treatment. Urinary RBP abnormalities were observed in patients during the first (n = 2), second (n = 8), third (n = 12), fourth (n = 15), and fifth (n = 22) year of ADV treatment. eGFR decreased 20%-30% from baseline in 20 patients, 30%-50% in 12 patients, and > 50% in 3 patients during the five years of treatment. Further analysis indicated that decreases in eGFR of ≥ 30% relative to the baseline level correlated significantly with urine RBP and β2-M abnormalities. In contrast, both serum creatinine and eGFR remained stable in patients treated with entecavir, and only one of these patients developed a urine β2-M abnormality, and two developed urine RBP abnormalities during the five years of treatment. CONCLUSION: Urine RBP and β2-M are biomarkers of renal injury during long-term ADV treatment for chronic hepatitis B, and indicate when treatment should be switched to entecavir.
Authors: Yoon-Seon Lee; Dong Jin Suh; Young-Suk Lim; Suk Won Jung; Kang Mo Kim; Han Chu Lee; Young-Hwa Chung; Yung Sang Lee; Wangdon Yoo; Soo-Ok Kim Journal: Hepatology Date: 2006-06 Impact factor: 17.425
Authors: Patrick Marcellin; Ting-Tsung Chang; Seng Gee Lim; Myron J Tong; William Sievert; Mitchell L Shiffman; Lennox Jeffers; Zachary Goodman; Michael S Wulfsohn; Shelly Xiong; John Fry; Carol L Brosgart Journal: N Engl J Med Date: 2003-02-27 Impact factor: 91.245
Authors: Stephanos J Hadziyannis; Nicolaos C Tassopoulos; E Jenny Heathcote; Ting-Tsung Chang; George Kitis; Mario Rizzetto; Patrick Marcellin; Seng Gee Lim; Zachary Goodman; Michael S Wulfsohn; Shelly Xiong; John Fry; Carol L Brosgart Journal: N Engl J Med Date: 2003-02-27 Impact factor: 91.245