Factors Associated with Renal Impairment in Patients on Tenofovir for Chronic Hepatitis B in Yaoundé (Cameroon)
- 1 Hepato Gastroenterologist Service, Yaoundé General Hospital, Yaoundé, Cameroon
- 2 Department of Clinical Sciences, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
- 3 Internal Medicine Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- 4 Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- 5 Hepato Gastroenterologist Service, Centre Medical la Cathedrale, Yaoundé, Cameroon
- 6 Hepato Gastroenterologist Service, Yaoundé General Hospital, Yaoundé, Cameroon
- 7 Internal Medicine Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- 8 Internal Medicine Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- 9 Nephrologist Service, Yaoundé General Hospital, Yaoundé, Cameroon
Abstract
Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of < 0.05 was significant. Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (<60 mL/min/1.73m2) was 6/60 (10%), the prevalence of hypophosphatemia 6/60 (10%) and the prevalence of albuminuria 24/60 (40%). Factors associated with eGFR reduced were diuretic use (OR 8.5, [1.09-9.58], p = 0.042) and duration of TFV ≥ 36 months (OR 34, [4.3-266.3], p = 0.001). Those associated with hypophosphatemia were duration of TFV ≥ 36 months (OR 12.5 [1.88-83.3], p = 0.009). While factors associated with albuminuria were TDF prodrug use (OR 8.8 [1.8-43.1], p = 0.009), and duration of TFV ≥ 36 months (OR 11.7, [CI 1.3-104.5], p = 0.009). Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.
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