Effect of tenofovir disoproxil fumarate on renal function in pregnant women with hepatitis B virus infection
10.3760/cma.j.cn114015-20220427-00372
- VernacularTitle:富马酸替诺福韦二吡呋酯对乙型肝炎病毒感染孕妇肾功能的影响
- Author:
Mingfang ZHOU
1
;
Wenjing WANG
1
;
Hongli JIANG
1
;
Fuchuan WANG
1
;
Wei YI
1
Author Information
1. 首都医科大学附属北京地坛医院妇产科，北京 100015
- Publication Type:Journal Article
- Keywords:
Hepatitis B virus;
Pregnancy;
Maternal exposure;
Tenofovir;
Kidney function tests;
Infectious disease transmission, vertical;
Safety
- From:
Adverse Drug Reactions Journal
2023;25(1):28-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of tenofovir disoproxil fumarate (TDF) treatment on renal function for preventing mother-to-infant transmission of hepatitis B virus (HBV) in pregnant women during the second and third trimester of pregnancy.Methods:The subjects were selected from pregnant women with HBV infection who were registered in Department of Gynecology and Obstetrics, Beijing Ditan Hospital, Capital Medical University and delivered between January and December 2021. The pregnant women who had HBV DNA ≥2.0×10 5 IU/ml and took TDF at 24-28 weeks of gestation were included in treatment group, and the pregnant women who had HBV DNA <2.0×10 5 IU/ml and did not use anti-HBV drugs during pregnancy were included in control group. The medical records data of pregnant women in the 2 groups were collected, including urine routine examination, liver function, renal function, estimated glomerular filtration rate (eGFR), blood phosphorus, serum markers of hepatitis B, HBV DNA, ect. at 24-28 weeks of gestation (baseline data), renal function, eGFR, serum phosphorus at 36-37 weeks of gestation, delivery, and 42 days postpartum, and adverse events related to renal tubular injury. Serum creatinine (Scr), blood urea nitrogen, eGFR, and blood phosphorus at baseline level, 36-37 weeks, delivery and 42 days postpartum, and changes of Scr and blood phosphorus before and after treatment between the 2 groups were compared, and adverse events related to renal tubular injury in the treatment group were recorded. Results:A total of 189 pregnant women were entered in the analysis, including 106 in the treatment group and 83 in the control group. The differences in age, proportion of primipara, baseline level of alanine aminotransferase, Scr, blood urea nitrogen, eGFR and blood phosphorus between the 2 groups were not statistically significant (all P>0.05), but the proportion of HBeAg-positive women and HBV DNA level in the treatment group were significantly higher than those in the control group (all P<0.05). The differences in Scr, blood urea nitrogen, eGFR, and blood phosphorus between the treatment group and the control group at 36-37 weeks of gestation, delivery and 42 days postpartum were not statistically significant (all P>0.05). The trends of changes in Scr, blood urea nitrogen, eGFR, and blood phosphorus from baseline level to 42 days postpartum were similar between 2 groups (all P>0.05). None of the pregnant women in the treatment group had adverse events related to renal tubular injury, such as hypophosphatemia, elevated Scr, renal hypouricemia, β2-microglobulinuria, non-diabetic glycosuria, metabolic acidosis, etc. Conclusion:TDF is safe for the kidney in the second and third trimester of pregnancy to strengthen the blocking of mother-to-infant transmission of HBV.
