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Clinical pharmacy and clinical trials (including case series)
Lipid-lowering effect of tenofovir in patients with chronic hepatitis B
  1. J. Sánchez-Rubio Ferrández,
  2. C. Apezteguia Fernández,
  3. E. Matilla García,
  4. M.P. Bautista Sanz,
  5. E. Fernández Esteban,
  6. R. Moreno Díaz
  1. 1Hospital Infanta Cristina, Pharmacy Department, Parla (Madrid), Spain


Background Some studies have suggested a lipid-lowering effect of tenofovir (TDF) in HIV infected patients who take antiretroviral therapy. Whether this effect appears in other kinds of patients remains unknown.

Purpose To assess the lipid-lowering effects of TDF in patients with chronic hepatitis B.

Materials and methods Retrospective single-institution study. Inclusion criteria: adults with chronic hepatitis B, not HIV-co-infected, treated with tenofovir since 2009. The authors included patients treated with TDF for at least one month and a baseline value for total cholesterol levels (TC) and triglycerides.

Demographics (age, sex) and treatment data (prior antiviral treatment, lipid-lowering treatment) were collected. TC and baseline triglycerides values were compared with those obtained 3-6 months after the start of treatment. Mean values were compared using Student's two-tailed test for paired samples.

Results Eighteen patients were included. Ten patients (56%) were male. Mean (±SD) age was 47.7±10.8 years. None of the patients took lipid-lowering agents at baseline or during the study. Seven patients (38.9%) received other hepatitis B treatment before tenofovir. Only one patient took another antihepatitis drug combined with TDF. At baseline, the mean±SD lipids (mg/dl) were 202.4±38.9 for TC and 96.2±45.2 for triglycerides. After 3-6 months of tenofovir treatment mean values were 174.6±30.9 for total cholesterol and 97.2±49,2 mg/dl for triglycerides. The TC levels of 16 patients (89%) improved with a mean reduction of 27.6 mg/dl (CI 95% 12.8-42,3) which is a statistically significant difference (p=0.001). Triglycerides did not improve significantly (difference-1.0 mg/dl CI 95% -20.9 to 18.9; p=0.917). These results are consistent with those found in HIV-infected patients.

Conclusions TC decreased significantly over the study period for most patients. TDF did not seem to have a positive effect on triglycerides. These data give the first evidence of a lipid-lowering effect of TDF in chronic hepatitis B patients although it must be confirmed in a prospective study.

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