Decrease of Serum Angiotensin Converting Enzyme Levels Upon Telbivudine Treatment for Chronic Hepatitis B Virus Infection and Negative Correlations Between the Enzyme Levels and Estimated Glumerular Filtration Rates

作者：Liang Kung Hao^*; Chen Yi Cheng; Hsu Chao Wei; Chang Ming Ling; Yeh Chau Ting

来源：Hepatitis Monthly, 2014, 14(1): e15074.

DOI：10.5812/hepatmon.15074

• Hepatitis B
• Nucleosides
• Antiviral Agents
• Kidney

Background: During antiviral therapy for chronic hepatitis B, renal function impairment could be a critical concern when oral nucleot(s) ide analogues were used. Paradoxically, long-term telbivudine treatment was associated with an increase of estimated glomerular filtration rate (eGFR) through unknown mechanisms. %26lt;br%26gt;Objectives: We aimed to investigate changes in serum protein abundances associated with renal function in response to antiviral treatments. %26lt;br%26gt;Materials and Methods: Primarily, a transcriptomic assay was performed to identify differentially expressed genes in peripheral blood cells caused by the telbivudine treatment. Two genes coding angiotensin converting enzyme (ACE) and complement factor H (CFH) were screened from 14 candidate renal function-related genes. ACE and CFH production were further investigated using enzyme-linked immunoassays. %26lt;br%26gt;Results: Verification studies showed no significant change of serum CFH levels, but there was a significant reduction of serum ACE levels by continuous telbivudine treatment for 330.00 +/- 0.85 days (34 patients; paired t-test, P = 0.022). Serum HBV DNA and ALT levels also decreased (P = 0.008 and %26lt; 0.001, respectively). A significant increase in eGFR was found (33 patients, paired t-test, P = 0.002) at 708.64 +/- 31.63 days. Patients%26apos; eGFRs were negatively correlated with serum ACE levels (r = -0.375, P = 0.002) but not with serum HBV DNA and ALT levels (P = 0.241 and 0.088 respectively). Significant decreases of the ACE levels were also observed upon entecavir treatment (20 patients; paired t-test, P = 0.020) at 412.88 +/- 36.92 days. No significant correlation was found between serum ACE levels and eGFRs (r = -0.239, P = 0.138) in entecavir-treated patients. %26lt;br%26gt;Conclusions: We discovered a consistent reduction of serum ACE levels by two oral antiviral monotherapies, entecavir and telbivudine. Serum ACE levels were negatively correlated with eGFRs in telbivudine treated patients.

• 出版日期2014-1
• 单位长春大学