1
|
Liegeon G, Ngo-Giang-Huong N, Salvadori N, Bunpo P, Cressey R, Achalapong J, Kanjanavikai P, Na Ayudhaya OP, Prommas S, Siriwachirachai T, Sabsanong P, Mary JY, Jourdain G. Proximal tubular dysfunction in pregnant women receiving tenofovir disoproxil fumarate to prevent mother-to-child transmission of hepatitis B virus. J Antimicrob Chemother 2022; 77:1111-1118. [PMID: 35045168 DOI: 10.1093/jac/dkab490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/01/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Data evaluating the risk of proximal tubular dysfunction in women receiving tenofovir disoproxil fumarate for the prevention of mother-to-child transmission (PMTCT) of HBV are scarce. OBJECTIVES To assess the risk of proximal tubulopathy in pregnant women receiving tenofovir disoproxil fumarate for PMTCT of HBV. PATIENTS AND METHODS We used urine samples collected from HBV monoinfected pregnant women who participated in a Phase III, multicentre, randomized, double-blind, placebo-controlled clinical trial assessing a tenofovir disoproxil fumarate short course from 28 weeks gestational age (28-wk-GA) to 2 months post-partum (2-months-PP) for PMTCT of HBV in Thailand. Markers of tubular dysfunction, including retinol binding protein, kidney injury molecule-1, α1-microglobuin and β2-microglobulin, were assayed at 28- and 32-wk-GA and 2-months-PP visits. Proximal tubulopathy was defined as the presence of ≥2 of the following: tubular proteinuria, euglycaemic glycosuria and increased urinary phosphate. RESULTS A total of 291 women participated in the study. No kidney-related adverse events were severe, and none led to tenofovir disoproxil fumarate discontinuation. At 2-months-PP, 3 of the 120 (3%) evaluated women in the tenofovir disoproxil fumarate group experienced proximal tubulopathy versus 3 of 125 (2%) in the placebo group (P = 1.00). None of the six women met the criteria for proximal tubulopathy at 12-months-PP but proteinuria persisted in three of them. No growth abnormalities were found at 1 year of age in infants born to mothers with proximal tubulopathy at 2-months-PP. CONCLUSIONS In these HBV-infected pregnant and breastfeeding women, tenofovir disoproxil fumarate administered from 28-wk-GA to 2-months-PP was not associated with a higher risk of proximal tubulopathy.
Collapse
Affiliation(s)
- Geoffroy Liegeon
- Department of Infectious Diseases, Hôpital Saint-Louis et Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France.,MIVEGEC, Université Montpellier, CNRS, IRD, Montpellier, France
| | - Nicole Ngo-Giang-Huong
- MIVEGEC, Université Montpellier, CNRS, IRD, Montpellier, France.,Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Nicolas Salvadori
- MIVEGEC, Université Montpellier, CNRS, IRD, Montpellier, France.,Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Piyawan Bunpo
- Division of Clinical Chemistry, Faculty of Associated Medical Sciences, Chiang Mai University, Thailand
| | - Ratchada Cressey
- Division of Clinical Chemistry, Faculty of Associated Medical Sciences, Chiang Mai University, Thailand
| | | | | | | | - Sinart Prommas
- Department of Obstetrics, Bhumibol Adulyadej Hospital, Bangkok, Thailand
| | | | - Prapan Sabsanong
- Department of Obstetrics, Samutsakhon Hospital, Samutsakhon, Thailand
| | - Jean Yves Mary
- INSERM U1153, Team ECSTRA, Université Paris Diderot - Paris 7, Hôpital Saint-Louis, Paris, France
| | - Gonzague Jourdain
- MIVEGEC, Université Montpellier, CNRS, IRD, Montpellier, France.,Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | |
Collapse
|
2
|
Zhu S, Yang YH, Gao RW, Li R, Zou YZ, Feng L, Zhang B. Clinical features of hypophosphatemic osteomalacia induced by long-term low-dose adefovir dipivoxil. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 12:41-45. [PMID: 29343941 PMCID: PMC5747959 DOI: 10.2147/dddt.s140988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective To investigate the predictors of hypophosphatemic osteomalacia induced by adefovir dipivoxil (ADV) and to monitor for early detection. Patients and methods Hospitalized patients who were diagnosed with ADV-related hypo-phosphatemic osteomalacia were recruited and retrospectively analyzed in our hospital from January 2012 to December 2016. A telephone interview was conducted at 1, 3, 6, 9, 12, and 24 months after cessation of ADV. Results In the 8 patients enrolled in the study, the hypophosphatemic osteomalacia symptoms developed at an average of 5.14 (4–7) years since ADV treatment (10 mg/d). The average alkaline phosphatase (ALP) level was 279.50 (137–548) U/L, which was significantly higher than the normal level (45–125 U/L). The serum phosphorus level was an average of 0.59 (0.43–0.69) mmol/L, which was lower than the normal range (2.06–2.60 mmol/L). Serum calcium levels of the enrolled patients remained within normal limits. Reduced estimated glomerular filtration rate (eGFR <29 mL/min/1.73 m2) was seen in 4 cases. The clinical manifestations were mainly progressive systemic bone and joint pain, frequent fractures, trouble in walking, height reduction (4–6 cm), and so on. After cessation of ADV, symptoms like bone pain resolved gradually. Serum phosphorus level restored to normal in 4.5 months after the withdrawal of ADV. However, in 4 patients, renal function failed to return to normal in 24 months. Conclusion More attention should be paid to the duration of ADV treatment. The level of serum phosphorus and ALP, as well as renal function, should be monitored for early detection of potential adverse drug reactions.
Collapse
Affiliation(s)
- Sheng Zhu
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yu-Hui Yang
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Rong-Wei Gao
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Ran Li
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yu-Zhen Zou
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Lei Feng
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Bo Zhang
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| |
Collapse
|
3
|
Reversal of Proximal Renal Tubular Dysfunction after Nucleotide Analogue Withdrawal in Chronic Hepatitis B. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4327385. [PMID: 29214169 PMCID: PMC5682049 DOI: 10.1155/2017/4327385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 10/03/2017] [Indexed: 02/06/2023]
Abstract
Aims Proximal renal tubular dysfunction (PRTD) is an infrequent complication after nucleotide analogue therapy. We evaluated the outcomes of PRTD and nephrotoxicity after nucleotide analogue withdrawal in chronic hepatitis B (CHB). Methods A longitudinal follow-up study was performed in patients with PRTD after nucleotide analogue discontinuation. Serum and urine were collected at baseline and every 3 months for one year. The fractional excretion of phosphate (PO4), uric acid (UA), and potassium and tubular maximal reabsorption rate of PO4 to glomerular filtration rate (TmPO4/GFR) were calculated. Renal losses were defined based on the criteria of substance losses. Subclinical PRTD and overt PRTD were diagnosed when 2 and ≥3 criteria were identified. Results Eight subclinical and eight overt PRTD patients were enrolled. After nucleotide analogue withdrawal, there were overall improvements in GFR, serum PO4, and UA. Renal loss of PO4, UA, protein, and β2-microglobulin reduced over time. At one year, complete reversal of PRTD was seen in 13 patients (81.2%). Improvements in PRTD were seen in all but one patient. Conclusion One year after nucleotide analogue withdrawal, PRTD was resolved in most patients. Changes in TmPO4/GFR, urinary protein, and β2-microglobulin indicate that urinary biomarkers may represent an early sign of PRTD recovery.
Collapse
|