Abstract:
Background: To study the prognosis and renal function changes of patients with chronic hepatitis B who receiving oral antiviral treatment over the past six years .
Methods: A retrospective and prospective cohort consisting of 162 patients who regularly took first-line antiviral drugs were diagnosed and treated in the Department of Gastroenterology, Huairou Hospital, Beijing was constructed. From February 2018 to February 2024, Among them, 108 patients were treated with ETV , 54 patients were treated with TDF. Their baseline, 1 year, 2 years, 3 years, 4 years, 5 years, and 6 years' HBV-DNA, kidney function, blood routine, coagulation function, blood calcium, blood phosphorus, β 2-microglobulin, and glomerular filtration rate (eGFR) were collected, and the incidence of cirrhosis and hepatocellular carcinoma in the past 6 years were ana lyzed.
Results: 162 patients were enrolled, with an average age of (52±10.6) years. Among them, 36 were HBeAg positive and 126 were HBeAg negative. During the 6-year follow-up period, 2 cases died ,One case of liver cancer and three cases of liver cirrhosis occurred in the TDF group..Four cases of liver cancer and four cases of liver cirrhosis oc curred in the ETV group. Clearance of hepatitis B surface antigen: 2 cases of surface antigen became negative after NUCs treatment (12 years of treatment), 4 cases of spontaneous negative (of which One case progressed to hepato cellular carcinoma after surface antigen became negative).HBV-DNA status: During the 6-year follow-up period, 3 patients developed hypoviremia (less than 200IU/ml), while the HBV-DNA of remaining patients remained below the detection limit. There was no significant difference in HGB, PLT, ALB, cholinesterase levels,blood calcium, blood phosphorus, blood creatinine, bloodβ2-microglobulin, INR and glomerular filtration rate (eGFR) at 1, 2, 3, 4, 5, and 6 years in two groups of patients (P>0.05).
Conclusion: Long term use of ETV and TDF has no significant effect on renal function in patients with hepatitis B. Even if hepatitis B surface antigen (HBsAg) becomes negative, there remains a risk of progression to hepatocellular carcinoma, close clinical monitoring is still necessary.
