Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Nucleotide analogues are associated in the long term with a risk of proximal tubular nephropathy (PT) with loss of phosphate, and, when compensatory mechanisms are overwhelmed, with osteopenia or osteoporosis. This toxicity has been particularly documented for tenofovir (TDF) in HIV disease, but its prevalence varies widely in the literature and is mainly associated with comorbidities: on average this prevalence is 0.39% after 48 weeks with exceptional cases of Fanconi syndrome described. In HBV monoinfection after 60 months of treatment with TDF, an 11% decrease of creatinine clearance (CreatCl) is observed. A single study showed a significant increase in creatinine level with entecavir (ETV) therapy, a second-generation nucleoside, hitherto not described as nephrotoxic. Furthermore, if the direct renal toxic effect characteristic of HIV in the kidney is well known, the role of HBV is less clear. Thus, HBV treatment appears to have a renal protective effect. The monitoring tools recommended by the SPC, CreatCl and plasma phosphorus level are late markers of tubular damage. The threshold of phosphate tubular reabsorption (TmPi/GFR) and the fractional excretion of uric acid (FEUA) are unexpensive early screening tools. However, the long-term evolution of this subclinical tubular involvement in HBV monoinfection is not known.
260 naive untreated patients, 220 patients treated with TDF and 220 patients treated with ETV and consecutively recruited in this interventional study, will have at baseline and every three months, a determination of phosphorus, creatinine, uric acid in plasma and urine samples for determination of TMPi / GFR and FEUA, and an evaluation of urinary calcium level. Depending on local opportunities, every six months, a urine sample will be stored in a declared biological collection to perform β2-microglobuline and cystatin dosage. A 25-OHD3 and PTH dosage will be conducted annually. A sample of genomic DNA will be collected after informed consent of the patient from a saliva sample (Saliva autocollection kits) in order to investigate genetic polymorphism in transporters responsible for the renal elimination of TDF and ETV. A serum sample will be stored at baseline, at one year and at endpoint for the retrospective dosage of bone markers (bone PAlk, PINP and CTX).
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patient naive | Patient with hepatitis B virus naive untreated |
| |
| Patient with TDF | Patient with hepatits B treated with Tenofovir |
| |
| Patient with ETV | Patient with hepatitis B virus treated with Entecavir |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| plasma and urine samples, sample with ADN | Biological | plasma and urine samples every three months Sample with ADN at baseline |
|
| Measure | Description | Time Frame |
|---|---|---|
| the prevalence of "subclinical" proximal tubular abnormalities | to compare at 2 years the prevalence of "subclinical" proximal tubular abnormalities (TmPi/GFR and FEUA) in 3 groups of HBV monoinfected patients treated with TDF, ETV or untreated. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| the prevalence at baseline of "subclinical" proximal tubular abnormalities | to describe the prevalence at baseline, and the cumulative incidence of these abnormalities during the follow-up and determine the proportion of patients who present at 2 years an impaired CreatCl, an hypophosphatemia and an hypercalciuria (suggesting a bone impact), according to the presence or absence of "subclinical" proximal tubular abnormalities. |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Patient with hepatitis B virus
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU d'Amiens | Amiens | 80054 | France | |||
| CHU d'Angers |
Not provided
Not provided
Not provided
Not provided
Plasma and urine samples for determination of TMPi / GFR and FEUA A sample of genomic DNA will be collected after informed consent of the patient from a saliva sample (Saliva autocollection kits) in order to investigate genetic polymorphism in transporters responsible for the renal elimination of TDF and ETV.
| 1 day |
| Angers |
| 49933 |
| France |
| CHU de Besancon | Besançon | 25000 | France |
| CHU de Bordeaux - Hôpital Saint André | Bordeaux | 33000 | France |
| CHU de Brest | Brest | 29609 | France |
| CHU de CAEN | Caen | 14033 | France |
| CHU de Clermont Ferrand | Clermont-Ferrand | 63003 | France |
| AP-HP - Hôpital Beaujon | Clichy | 92110 | France |
| Centre Hospitalier Laennec de Creil | Creil | 60109 | France |
| Centre Hospitalier d'Hyères | Hyères | 83407 | France |
| Centre Hospitalier de La Roche sur Yon | La Roche-sur-Yon | 85925 | France |
| AP-HP - Hôpital Kremlin Bicêtre | Le Kremlin-Bicêtre | 94275 | France |
| CHU de Lille - Hôpital Huriet | Lille | 59037 | France |
| CHU de Limoges - Fédération Hépatologie | Limoges | 87042 | France |
| Hospices Civils de Lyon - Hôpital Croix Rousse | Lyon | 69317 | France |
| CHU de Montpellier - Hôpital Saint Eloi | Montpellier | 34295 | France |
| CHU de Nice | Nice | 06202 | France |
| AP-HP - Hôpital La Pitié Salpétrière | Paris | 75651 | France |
| AP-HP - Hôpital Bichat | Paris | 75877 | France |
| CHU de Bordeaux - Hôpital Haut Levêque | Pessac | 33604 | France |
| CHU de Point à Pitre | Point À Pitre | 97159 | France |
| CHU de Poitiers | Poitiers | 86021 | France |
| CHU de Strasbourg - Hôpital Civil | Strasbourg | 67091 | France |
| CHU de Tours - Hôpital Trousseau | Tours | 37044 | France |
| CHU de Nancy - Hôpital Brabois | Vandœuvre-lès-Nancy | 54511 | France |
| ID | Term |
|---|---|
| D006509 | Hepatitis B |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D018347 | Hepadnaviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D006525 | Hepatitis, Viral, Human |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
Not provided
Not provided