Tenofovir alafenamide easy on CHB patients with renal, bone mineral density problems

In chronic hepatitis B (CHB) patients with renal and/or bone mineral density (BMD) disorders or risks, treatment with tenofovir alafenamide (TAF) leads to improvements in estimated glomerular filtration rate (eGFR) after 12–24 months, especially for patients with low eGFR levels at baseline, while maintaining virological suppression, according to data from HERACLIS-TAF.

HERACLIS-TAF included 176 patients who initiated TAF, with the majority (91 percent) switching from another agent, at 13 clinics throughout Greece. None of the patients had hepatitis D, active malignancy, and recent bisphosphonates use. Researchers used the Modification of Diet in Renal Disease (MDRD) formula to calculate eGFR.

Hepatitis B virus DNA was undetectable in 97 percent of patients at 12 months and in 100 percent at 24 months. Median alanine aminotransferase (ALT) dropped from baseline to months 12 and 24 (p<0.001). Mean eGFR declined from previous treatment initiation to baseline (p<0.001), then increased at 12 months and remained stable at 24 months (p≤0.001).

Of note, half of the population exhibited an increase in eGFR of >3 ml/min at 12 month. This occurred mostly among those with eGFR 30–60 ml/min.

Meanwhile, mean serum phosphate increased at months 12 and 24 (p<0.001) among patients with baseline phosphate <2.5 mg/dl. Median BMD, on the other hand, showed significant improvements at 24 months (p=0.001) but not at 12 months.