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Article: Extrahepatic effects of nucleoside and nucleotide analogues in chronic hepatitis B treatment

TitleExtrahepatic effects of nucleoside and nucleotide analogues in chronic hepatitis B treatment
Authors
Issue Date2014
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH
Citation
Journal of Gastroenterology and Hepatology, 2014, v. 29 n. 3, p. 428-434 How to Cite?
AbstractOral nucleoside/nucleotide analogues (NAs) are the mainstay of therapy for patients with chronic hepatitis B, and are generally well tolerated. Despite this, the safety profile of NAs is of paramount importance since the majority of patients will require long-term treatment. All NAs can potentially affect human DNA polymerase with decrease in mitochondrial DNA, leading to manifestations of mitochondrial toxicity. As a class effect therefore, NAs can potentially cause extra-hepatic conditions such as myopathy, nephropathy, neuropathy, and lactic acidosis. Indeed, effects on muscles including myopathy and creatine kinase elevations have been described with clevudine and telbivudine use. Both adefovir and tenofovir are associated with dose-dependent nephropathy, predominantly affecting the proximal renal tubules. Neuropathy appears to be rare, and most commonly reported in patients receiving combination therapy with telbivudine and interferon. Increased risk of lactic acidosis has also been described for those with impaired liver and renal function taking entecavir. Loss of bone mineral density and hypophosphatemia has been described with the use of nucleotide analogues, although the overwhelming studies have been with HIV-infected patients. However, not all extra-hepatic effects are detrimental. Recent evidence has suggested a potential renal beneficial effect with the use of telbivudine. The effect of NAs on pregnancy appears to be minimal for all NAs, with telbivudine and tenofovir having a more favorable category B rating. Ongoing pharmacovigilance is essential to identify new and monitor existing extra-hepatic effects associated with NA use.
Persistent Identifierhttp://hdl.handle.net/10722/193876
ISSN
2015 Impact Factor: 3.322
2015 SCImago Journal Rankings: 1.190
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFung, JYYen_US
dc.contributor.authorSeto, WKWen_US
dc.contributor.authorLai, CLen_US
dc.contributor.authorYuen, RMFen_US
dc.date.accessioned2014-01-28T06:30:44Z-
dc.date.available2014-01-28T06:30:44Z-
dc.date.issued2014en_US
dc.identifier.citationJournal of Gastroenterology and Hepatology, 2014, v. 29 n. 3, p. 428-434en_US
dc.identifier.issn0815-9319en_US
dc.identifier.urihttp://hdl.handle.net/10722/193876-
dc.description.abstractOral nucleoside/nucleotide analogues (NAs) are the mainstay of therapy for patients with chronic hepatitis B, and are generally well tolerated. Despite this, the safety profile of NAs is of paramount importance since the majority of patients will require long-term treatment. All NAs can potentially affect human DNA polymerase with decrease in mitochondrial DNA, leading to manifestations of mitochondrial toxicity. As a class effect therefore, NAs can potentially cause extra-hepatic conditions such as myopathy, nephropathy, neuropathy, and lactic acidosis. Indeed, effects on muscles including myopathy and creatine kinase elevations have been described with clevudine and telbivudine use. Both adefovir and tenofovir are associated with dose-dependent nephropathy, predominantly affecting the proximal renal tubules. Neuropathy appears to be rare, and most commonly reported in patients receiving combination therapy with telbivudine and interferon. Increased risk of lactic acidosis has also been described for those with impaired liver and renal function taking entecavir. Loss of bone mineral density and hypophosphatemia has been described with the use of nucleotide analogues, although the overwhelming studies have been with HIV-infected patients. However, not all extra-hepatic effects are detrimental. Recent evidence has suggested a potential renal beneficial effect with the use of telbivudine. The effect of NAs on pregnancy appears to be minimal for all NAs, with telbivudine and tenofovir having a more favorable category B rating. Ongoing pharmacovigilance is essential to identify new and monitor existing extra-hepatic effects associated with NA use.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH-
dc.relation.ispartofJournal of Gastroenterology and Hepatologyen_US
dc.rightsThe definitive version is available at www3.interscience.wiley.com-
dc.titleExtrahepatic effects of nucleoside and nucleotide analogues in chronic hepatitis B treatmenten_US
dc.typeArticleen_US
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hken_US
dc.identifier.emailSeto, WKW: wkseto2@hku.hken_US
dc.identifier.emailLai, CL: hrmelcl@hku.hken_US
dc.identifier.emailYuen, RMF: mfyuen@hku.hken_US
dc.identifier.authorityFung, JYY=rp00518en_US
dc.identifier.authoritySeto, WKW=rp01659en_US
dc.identifier.authorityLai, CL=rp00314en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/jgh.12499en_US
dc.identifier.pmid24372662-
dc.identifier.hkuros227482en_US
dc.identifier.hkuros230537-
dc.identifier.volume29-
dc.identifier.issue3-
dc.identifier.spage428-
dc.identifier.epage434-
dc.identifier.isiWOS:000331469400007-
dc.publisher.placeAustralia-

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