- Entecavir (ETV, Baraclude) is a safe and effective HBV rescue strategy for patients who develop tenofovir disoproxil fumarate (TDF; Viread)-related renal dysfunction.
Why this matters
- TDF nephrotoxicity can also be counteracted by switching to tenofovir alafenamide (Vemlidy), but ETV generics are widely available.
- Multicenter Italian study of 103 patients (median age, 64 years; 83% male) with TDF-associated glomerular and/or tubular dysfunction.
- Modification of Diet in Renal Disease (MDRD) formula used to estimate glomerular filtration rate (eGFR, in mL/minute/1.73 m2).
- Funding: Italian Ministry of Health.
- 98% had undetectable viral load; 49% were cirrhotic.
- 47% were lamivudine-resistant (LMV-R), 71% were adefovir (ADV)-experienced.
- Patients switched to TDF for eGFRMDRD
- At a median of 46 months, TDF yielded improvements in median:
- Creatinine levels (1.30-1.10 mg/dL; P<.0001>
- eGFRMDRD (54-65; P=.002).
- Blood phosphate levels (2.2-2.6 mg/dL; P<.0001>
- Maximal tubule phosphate reabsorption (0.47-0.62 mmol/L; P<.0001>
- LMV-R, 11%.
- LMV-experienced, 7%.
- LMV-naive, 0%.
- Open-label, retrospective, single-arm design.