2016, Number 2
<< Back Next >>
Ann Hepatol 2016; 15 (2)
Tenofovir-induced Fanconi syndrome in a patient with chronic hepatitis B monoinfection
Conti F, Vitale G, Cursaro C, Bernardi M, Andreone P
Language: English
References: 14
Page: 273-276
PDF size: 126.65 Kb.
ABSTRACT
Tenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor indicated for treatment of patients with chronic
hepatitis B virus (CHB) and human immunodeficiency virus (HIV) infections. Despite the good safety profile of the drug, Fanconi syndrome
is a possible adverse reaction of TDF treatment, especially in HIV-infected patients. Only a few cases have been reported in
patients with CHB-monoinfections. This report presents a case of a 58-year-old man with mild HBeAg-negative CHB who was exposed
to TDF and developed drug-induced Fanconi syndrome. Renal dysfunction reverted after TDF discontinuation and a switch to
entecavir, and viral replication remained suppressed. A literature review yielded six additional cases of TDF-induced Fanconi syndrome,
all with risk factors for renal dysfunction despite the patients having normal glomerular filtration rates. We discuss the overall
risk for Fanconi syndrome in CHB-monoinfected patients exposed to TDF and the importance of careful monitoring of glomerular and
tubular functions even when pre-existing kidney disease is not present.
REFERENCES
Pol S, Lampertico P. First-line treatment of chronic hepatitis B with entecavir or tenofovir in ‘real-life’ settings: from clinical trials to clinical practice. J Viral Hepat 2012; 19:377-86
Marcellin P, Gane E, Buti M, Afdhal N, Sievert W, Jacobson IM, Washington MK, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet 2013; 381: 468-75
Buti M, Tsai N, Petersen J, Flisiak R, Gurel S, Krastev Z, Aguilar Schall R, et al. Seven-year efficacy and safety of treatment with tenofovir disoproxil fumarate for chronic hepatitis B virus infection. Dig Dis Sci 2014 [Epub ahead of print].
Nelson MR, Katlama C, Montaner JS, Cooper DA, Gazzard B, Clotet B, Lazzarin A, et al. The safety of tenofovir disoproxilfumarate for the treatment of HIV infection in adults: the first 4 years. AIDS 2007; 21: 1273-81
Cooper RD, Wiebe N, Smith N, Keiser P, Naicker S, Tonelli M. Systematic review and meta-analysis: renal safety of tenofovir disoproxilfumarate in HIV-infected patients. Clin Infect Dis 2010; 51: 496-505
Hall AM, Hendry BM, Nitsch D, Connolly JO. Tenofovir-associated kidney toxicity in HIV-infected patients: a review of the evidence. Am J Kidney Dis 2011; 57: 773-80
Izzedine H, Launay-Vacher V, Isnard-Bagnis C, Deray G. Drug-induced Fanconi’s syndrome. Am J Kidney Dis 2003; 41: 292-309
Samarkos M, Theofanis V, Eliadi I, Vlachogiannakos J, Polyzos A. Tenofovir-associated Fanconi syndrome in a patient with chronic hepatitis B. J Gastrointestin Liver Dis 2014;23(3):342
Gracey DM, Snelling P, McKenzie P, Strasser SI. Tenofovirassociated Fanconi syndrome in patients with chronic hepatitis B monoinfection. Antivir Ther 2013; 18: 945-48
Viganň M, Brocchieri A, Spinetti A, Zaltron S, Mangia G, Facchetti F, Fugazza A, et al. Tenofovir-induced Fanconi syndrome in chronic hepatitis B monoinfected patients that reverted after tenofovir withdrawal. J Clin Virol 2014; 61(4): 600-3
Hwang HS, Park CW, Song MJ. Tenofovir-associated Fanconi syndrome and nephrotic syndrome in a patient with chronic hepatitis B monoinfection. Hepatology 2015 [Epub ahead of print].
European Association For the Study of The Liver (EASL) EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167-85
Röling J, Schmid H, Fischereder M, Draenert R, Goebel FD. HIV-associated renal diseases and highly active antiretroviral therapy-induced nephropathy. Clin Infect Dis 2006; 42 (10): 1488-95
Tenney DJ, Rose RE, Baldick CJ, Pokornowski KA, Eggers BJ, Fang J, Wichroski MJ, et al. Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naďve patients is rare through 5 years of therapy. Hepatology 2009; 49(5): 1503-14.