Influence of pegylated interferonα- 2a versus telbivudine on renal function in patients with chronic hepatitis B

Objective To investigate the influence of pegylated interferonα- 2a( PEG- IFNα- 2a) versus telbivudine( Ld T) on renal function in patients with chronic hepatitis B( CHB). Methods The clinical data of 92 previously untreated HBe Ag- positive CHB patients who participated in the CHB IV clinical trial in Tangdu Hospital of Fourth Military Medical University from July 2007 to March 2013 were analyzed retrospectively,and among these patients,39 received subcutaneous injection of PEG- IFNα- 2a 180 μg / week( PEG- IFNα- 2a group) and 53 received antiviral therapy with Ld T 600 mg / d( Ld T group). The HBV DNA clearance rate,alanine aminotransferase( ALT)normalization rate,serum creatinine,urea nitrogen,and estimated glomerular filtration rate( e GFR) at baseline and weeks 24 and 48 of treatment were calculated and analyzed,and e GFR was calculated by Chronic Kidney Disease Epidemiology Collaboration( CKD- EPI) or Modification of Diet in Renal Disease( MDRD). The independent samples t- test was used for comparison of normally distributed continuous data between the two groups,and the Wilcoxon rank sum test was used for comparison of continuous data with non- normal distribution between the two groups; the repeated measures analysis of variance was used for comparison of data before and after treatment within one group,and Mauchly's test of sphericity was performed for data before the repeated measures analysis of variance; the chi- square test was used for comparison of categorical data between the two groups. Results In the PEG- IFNα- 2a group,serum creatinine decreased significantly at weeks 24 and 48 of treatment compared with the baseline value( 0. 68 ± 0. 11 mg / dl and 0. 67 ± 0. 11 mg / dl vs 0. 75 ± 0. 11 mg / dl,P<0. 000 1),and e GFR increased significantly at week 24 [128. 30 ± 10. 98 ml / min /1. 73 m2( CKD- EPI) or 143. 90 ± 25. 82 ml/min/1. 73m2( MDRD) ]and week 48 [128. 00 ± 10. 17 ml/min/1. 73 m2( CKD- EPI) or 144. 30 ± 24. 68 ml/min/1. 73 m2( MDRD) ] compared with the baseline value [123. 10 ± 9. 64 ml / min /1. 73 m2( CKD- EPI) or 127. 40 ± 20. 16 ml/min/1. 73 m2( MDRD) ]( P < 0. 000 1). In the Ld T group,serum creatinine( 0. 73 ± 0. 13 mg / dl) and e GFR [122. 30 ± 11. 22 ml / min /1. 73 m2( CKD- EPI) or 128. 10 ± 20. 67 ml/min /1. 73 m2( MDRD) ]at week 24 showed significant differences from those at baseline [serum creatinine: 0. 74 ± 0. 13 mg/dl; e GFR:121. 50 ± 11. 21 ml / min /1. 73 m2( CKD- EPI) or 126. 40 ± 20. 96 ml/min/1. 73 m2( MDRD) ]( P >0. 05); compared with the baseline values,serum creatinine at week 48( 0. 68 ± 0. 12 mg / dl) decreased significantly( P < 0. 000 1),while e GFR [125. 30 ± 11. 55 ml / min /1. 73 m2( CKD- EPI) or 138. 00 ± 25. 94 ml/min/1. 73 m2( MDRD) ]increased significantly( P < 0. 000 1). At week 48 of treatment,the Ld T group had significantly higher HBV DNA clearance rate and ALT normalization rate than the PEG- IFNα- 2a group( HBV DNA seroconversion rate: 60. 4% vs 38. 5%,χ~2= 6. 17,P = 0. 037; ALT normalization rate: 75. 5% vs 33. 3%; χ~2= 16. 34,P < 0. 000 1). Conclusion PEG- IFNα- 2a and Ld T do not influence renal function in CHB patients.