Antiviral treatment of chronic hepatitis B patients with renal insufficiency / 中华临床感染病杂志

ABSTRACT

Chronic hepatitis B (CHB) is an infectious disease characterized by liver damage, which can progress to liver fibrosis, cirrhosis, liver failure or liver cancer, threatening the life of patients. CHB patients are prone to be complicated with hepatitis B virus-associated glomerulonephritis and other kidney diseases, therefore the renal safety should be fully considered in the antiviral treatment of CHB patients. According to current guidelines, telbivudine, entecavir or tenofovir alafenamide are recommended for CHB patients with renal insufficiency or potential renal injury, but each has its advantages and disadvantages. How to carry out antiviral treatment in CHB patients with renal impairment deserves our attention. At the same time, the renal function should be monitored regularly in the course of antiviral treatment to identify the damage of renal function in the early stage. This article reviews the causes of renal dysfunction in CHB patients, the risk of kidney damage during the antiviral treatment, the choices of antiviral therapy and the monitoring of renal function in the patients.