JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (7): 73-78.doi: 10.6040/j.issn.1671-7554.0.2016.1063

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Hypophosphatemia during long-term adefovir dipivoxil therapy in patients with hepatitis B virus infection

LIU Qiuxia1, WANG Lei1, LIU Feng1, QU Yundong1, YE Qian1, QIAN Yu1, ZHANG Yuan2, ZHANG Lixin1   

  1. 1. Department of Hepatology;
    2. Center of Evidence-based Medicine, Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2016-08-26 Online:2017-07-10 Published:2017-07-10

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Abstract: Objective To assess the cumulative incidence of hypophosphatemia caused by long-term treatment with adefovir dipivoxil(ADV)in patients with hepatitis B virus(HBV)infection and to explore the risk factors. Methods The patients who received ADV monotherapy or ADV plus lamivudine(LAM)for more than 1 year were recruited. Serum phosphate level, serum creatinine and estimated glomerular filtration rate(eGFR)were evaluated. Cumulative incidences of hypophosphatemia were calculated with Kaplan-Meier method. Results Of the 243 cases involved, 171 were chronic hepatitis B(CHB)and 72 were liver cirrhosis(LC). During a median treatment duration of 66(12-120)months, 24 patients developed hypophosphatemia. The cumulative incidences of hypophosphatemia for CHB and LC cases during 2-10 years were 0.6%, 0.6%, 0.6%, 3.2%, 6.2%, 11.2%, 14.2%, 14.2%, 19.9%, and 1.5%, 3.3%, 7.9%, 10.4%, 13.7%, 23.9%, 32.3%, 49.3% and 49.3%, respectively(χ2=6.685, P=0.010). Multivariate analysis identified LC(HR=2.886, P=0.020)and ADV plus LAM(HR=2.661, P=0.010) 山 东 大 学 学 报 (医 学 版)55卷7期 -刘秋霞,等.慢性HBV感染患者长期服用阿德福韦酯与肾性低磷血症的相关因素 \=-as independent predictors of hypophosphatemia. Conclusion Long-term treatment of hepatitis B with ADV or ADV plus LAM can potentially cause hypophosphatemia. LC patients treated with ADV plus LAM are more likely to develop hypophosphatemia.

Key words: Adefovir dipivoxil, Hypophosphatemia, Chronic hepatitis B

CLC Number: 

  • R512.6
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