Comparison of kidney function decline between chronic hepatitis B patients with or without antiviral therapy

Background and Aims: Kidney function can deteriorate in patients with chronic hepatitis B (CHB). We compared the risk of kidney function decline between untreated and treated CHB patients receiving antiviral therapy.Methods: This retrospective study included 1061 untreated CHB patients and 366 tenofovir alafenamide (TAF), 190 besifovir dipivoxil maleate (BSV), and 2029 entecavir (ETV) users. The primary outcome was kidney function decline, a >= one-stage increase in chronic kidney disease for =3 consecutive months.Results: The incidence and risk of kidney function decline were significantly higher in the 1:1 propensity score matched treated group (588 pairs) than in the untreated (2.7 per 1000 person-years [PYs] vs. 1.3 per 1000 PYs, adjusted hazard ratio [aHR] = 2.29, all p < 0.001). The matched TAF group (222 pairs) showed a similar risk for the primary outcome (aHR = 1.89, p = 0.107) despite a significantly higher incidence thereof, compared to the untreated (3.9 vs. 1.9 per 1000 PYs, p = 0.042). The matched BSV and untreated groups (107 pairs) showed no significant differences in the incidence and risk. However, ETV users (541 pairs) carried a significantly higher outcome incidence and risk than the matched untreated (3.6 vs. 1.1 per 1000 PYs, aHR = 1.05, all p < 0.001). Compared to each matched untreated group, changes in the estimated glomerular filtration rate over time were greater in the ETV group (p = 0.010), despite being similar in the TAF (p = 0.073) and BSV groups (p = 0.926).Conclusions: Compared with untreated patients, TAF or BSV users showed similar risk, whereas ETV users showed a higher risk of kidney function decline.

Automated summary

This retrospective study compared the risk of kidney function decline between untreated and treated chronic hepatitis B (CHB) patients receiving antiviral therapy. The study found that compared to untreated patients, the risk was similar for patients using TAF or BSV, but higher for patients using ETV.