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A novel evidence of serial changes of bone mineral density in chronic hepatitis B patients treated with entecavir

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Abstract

Background and aims

Tenofovir disoproxil fumarate (TDF) and Entecavir (ETV) are commonly used for patients with chronic hepatitis B (CHB), and renal or bone toxicity are possible concerns. This study is to evaluate the renal and bone effect of TDF compared with ETV in CHB patients.

Methods

This is a retrospective study at Kaohsiung Chung-Gung memorial hospital, Taiwan, from June 2013 to December 2018. Patients with CHB were prescribed with TDF or ETV for 3 years or above. Renal function was assessed at 12-week intervals. Dual-energy X-ray absorptiometry scans of the spine and femurs were performed at 48-week intervals. The propensity score analysis was conducted to balance the baseline characteristics of patients in both treatment groups.

Results

A total of 258 patients were included in this study: TDF (n = 135) and ETV (n = 123). The prevalence of osteopenia was much higher in the TDF group at week 48 and week 96. The TDF group showed significant mean percentage decrease from baseline in bone mineral density throughout the treatment course. Logistic regression analysis adjusted for the propensity score demonstrated that the use of TDF was the only predictive factor of significant bone density loss at week 144. The mean percentage decline of estimated glomerular filtration rate was significant in the TDF group at all time points. Renal threshold phosphate concentration was similar among both treatment groups.

Conclusions

This study suggested CHB patients treated with TDF may experience increased risks of bone loss and renal deficits compared to those treated with ETV.

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Abbreviations

TDF:

Tenofovir disoproxil fumarate

ETV:

Entecavir

HBsAg:

Hepatitis B surface antigen

DEXA:

Dual-energy X-ray absorptiometry

NAs:

Nucleos(t)ide analogues

ADV:

Adefovir

HIV:

Human immunodeficiency virus

BMD:

Bone mineral density

CHB:

Chronic hepatitis B

HCC:

Hepatocellular carcinoma

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Acknowledgements

We appreciated the Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital and Sherry Yueh-Hsia Chiu for statistics work.

Funding

There is no financial support related to this study.

Author information

Authors and Affiliations

  1. Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Dist, Kaohsiung City, 83301, Taiwan

    Pao-Yuan Huang, Sherry Yueh-Hsia Chiu, Kuo-Chin Chang, Po-Lin Tseng, Yi-Hao Yen, Ming-Chao Tsai, Jing-Houng Wang, Kwong-Ming Kee, Chien-Hung Chen, Chao-Hung Hung, King-Wah Chiu & Tsung-Hui Hu

  2. Department of Health Care Management, College of Management; and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan

    Sherry Yueh-Hsia Chiu

  3. School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Kuo-Chin Chang, Po-Lin Tseng, Yi-Hao Yen, Ming-Chao Tsai, Jing-Houng Wang, Kwong-Ming Kee, Chien-Hung Chen, Chao-Hung Hung, King-Wah Chiu & Tsung-Hui Hu

Authors
  1. Pao-Yuan Huang
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Contributions

Pao-Yuan Huang codesigned the study, acquired, analyzed, and interpreted the data, and drafted the manuscript. Sherry Yueh-Hsia Chiu performed the statistical analysis, analyzed and interpreted the data, and drafted the manuscript. Kuo-Chin Chang, Po-Lin Tseng, Yi-Hao Yen, Ming-Chao Tsai, Jing-Houng Wang, Kwong-Ming Kee, Chien-Hung Chen, Chao-Hung Hung, King-Wah Chiu acquired, analyzed, and interpreted the data. Tsung-Hui Hu designed the study, supervised the project, acquired, analyzed, and interpreted the data, drafted the manuscript, revised the manuscript critically.

Corresponding author

Correspondence to Tsung-Hui Hu.

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Conflict of interest

None of the authors have any conflicts of interest.

Ethical approval

The study protocol was approved by the institutional review board and the Ethics Committee of Chang Gung Memorial Hospital (IRB No: 201900928B0).

Informed consent

The Ethics Committee waived the requirement for informed consent for this study, and all the data were analyzed anonymously.

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Huang, PY., Chiu, S.YH., Chang, KC. et al. A novel evidence of serial changes of bone mineral density in chronic hepatitis B patients treated with entecavir. Hepatol Int 15, 310–317 (2021). https://doi.org/10.1007/s12072-021-10148-z

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  • DOI: https://doi.org/10.1007/s12072-021-10148-z

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