{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:40:01Z","timestamp":1747186801743,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,4]],"date-time":"2020-10-04T00:00:00Z","timestamp":1601769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Tenofovir disoproxil fumarate (TDF) effectively suppresses viral replication in chronic hepatitis B (CHB), but occasionally leads to renal impairment. We evaluated the prevalence of viral and biochemical breakthrough and renal function kinetics in renally impaired patients with CHB on reduced and on full\u2010dose TDF. This clinic\u2010based longitudinal cohort study included patients receiving full and reduced dose TDF (due to eGFR [Cockcroft\u2010Gault] &lt;60\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>). Viral and biochemical breakthroughs were assessed 1\u00a0month after starting full and reduced TDF dose until the end\u2010of\u2010follow\u2010up. Breakthroughs were studied in full and reduced dose TDF, and renal function (MDRD) longitudinally before and after dose reduction within patients starting on full\u2010dose TDF. Of 750 patients on TDF, 78 (10%) had reduced dose and 672 (90%) full dose. At the time of dose reduction, 36 (46%) patients had chronic kidney disease stage G3B. A viral breakthrough occurred in one cirrhotic dialysis\u2010dependent patient (dosed 300\u00a0mg weekly) which resolved without signs of decompensation, and in one patient on full dose which resolved spontaneously. One biochemical breakthrough occurred during dose reduction and resolved naturally without viral breakthrough. The MDRD improved within the first year of dose reduction (+3.0 [2.5]\u00a0mL\/min per year; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.005) and remained stable thereafter. Fifty\u2010three (79%) patients reached an MDRD &gt;50\u00a0mL\/min during dose reduction. Low dose TDF maintains renal function and viral suppression in most renally impaired patients with CHB, even in those with advanced liver disease. This useful, yet simple strategy could be particularly viable in resource\u2010constrained settings.<\/jats:p>","DOI":"10.1111\/jvh.13401","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T20:26:55Z","timestamp":1601324815000},"page":"51-60","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maintained virological suppression and renal function with reduced dose tenofovir disoproxil fumarate in renally impaired chronic hepatitis B patients"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3585-2778","authenticated-orcid":false,"given":"Kin Seng","family":"Liem","sequence":"first","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital University Health Network Toronto ON Canada"},{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David K.","family":"Wong","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Fung","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alireza","family":"Zahirieh","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colina","family":"Yim","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayel R.","family":"Zanjir","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan J.","family":"Feld","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital University Health Network Toronto ON Canada"},{"name":"McLaughlin\u2010Rotman Centre for Global Health Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina E.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital University Health Network Toronto ON Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry L. 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