J Liver Cancer.  2019 Sep;19(2):128-135. 10.17998/jlc.19.2.128.

Tenofovir and Entecavir Have Similar Renal Adverse Events on Hepatocellular Carcinoma Patients Treated with Transarterial Chemoembolization

• Cho YY
• Choi YH
• Yu SJ
• Cho EJ
• Lee JH
• Kim YJ
• Yoon JH

• KMID: 2463613
• DOI: http://doi.org/10.17998/jlc.19.2.128

Abstract

BACKGROUND/AIMS
Tenofovir disoproxil fumarate (TDF) is potentially nephrotoxic in chronic hepatitis B patients. Hepatocellular carcinoma (HCC) patients treated using transarterial chemoembolization (TACE) are at an increased risk of renal injury. The aim of this study was to determine whether TDF is associated with more renal adverse events than entecavir (ETV) in HCC patients treated with TACE.
METHODS
In this retrospective single-center study, we selected 53 HCC patients who were treated with TDF from January 2012 to July 2013 and had their first TACE procedure in the same period. These patients were matched by age and sex to patients treated with ETV.
RESULTS
There were no significant differences in baseline characteristics, including HCC factors, and nephrotoxic drug use, between the two groups. The median follow-up period was 17.0 and 20.0 months for the TDF and ETV groups, respectively. There was no difference during the follow-up period between the TDF and ETV groups in the increase in creatinine over 0.5 mg/dL (17.0% and 17.0%, P=1.00, respectively) and the decrease in eGFR over 25% (43.4% and 41.5%, P=0.84, respectively). Multivariate analysis revealed that Child-Pugh class over B (hazard ratio [HR], 7.30; 95% confidence interval [CI] 2.79-19.10; P<0.01) was associated with increase in creatinine, and Child-Pugh class over B (HR, 82.74; 95% CI 12.31-555.83; P<0.01) and Barcelona-Clinic Liver Cancer stage over B (HR, 14.93; 95% CI 1.60-139.51; P=0.02) were associated with decrease in eGFR.
CONCLUSIONS
TDF has comparable safety to that of ETV for HCC patients undergoing TACE.

Keyword

Hepatocelluar carcinoma; Transarterial chemoembolization; Hepatitis B, chronic; Kidney diseases; Antiviral agents

MeSH Terms

Antiviral Agents
Carcinoma, Hepatocellular*
Creatinine
Follow-Up Studies
Hepatitis B, Chronic
Humans
Kidney Diseases
Liver Neoplasms
Multivariate Analysis
Retrospective Studies
Tenofovir*
Antiviral Agents
Creatinine
Tenofovir

Figure

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  Figure 1. Patient selection. TDF, tenofovir; ETV, entecavir; TACE, transarterial chemoembolization.

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  Figure 2. Renal events of the tenofovir group compared to those of the entecavir group. (A) Kaplan-Meier curve of increase in creatinine over 0.5 mg/dL. (B) Kaplan-Meier curve of decrease in eGFR over 25%.*Chi-square test

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