PDF(Pubmed)
Abstract：
Tenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor that has been widely used for the treatment of patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infections. Despite the excellent safety records of this regimen, a few cases of acute renal failure and Fanconi syndrome have been reported among HIV patients exposed to TDF. However, in the HBV monoinfection scenario, only five cases of TDF-associated Fanconi syndrome have been reported thus far, two of them providing a confirmatory kidney biopsy. Here, we describe the case of a 68-year-old woman with chronic hepatitis B (CHB) who developed TDF-induced Fanconi syndrome that reverted after TDF withdrawal from tenofovir alafenamide. Though the overall risk of TDF-associated severe renal toxicity in HBV patients appears to be negligible, both glomerular and tubular functions should be monitored in patients exposed to TDF.
摘要：
富马酸替诺福韦酯（TDF）是一种核苷酸逆转录酶抑制剂，已被广泛用于治疗患有人类免疫缺陷病毒（HIV）和乙型肝炎病毒（HBV）感染的患者。尽管这个方案有极好的安全记录,在暴露于TDF的HIV患者中报道了一些急性肾功能衰竭和Fanconi综合征的病例。然而,在HBV单一感染的情况下，到目前为止，只有五例TDF相关的范可尼综合征被报道，其中两个提供了证实的肾活检。这里,我们描述了一名68岁的慢性乙型肝炎（CHB）女性，她发展了TDF诱导的Fanconi综合征，在TDF从替诺福韦艾拉酚胺退出后恢复。虽然在HBV患者TDF相关的严重肾毒性的总体风险似乎是微不足道的，暴露于TDF的患者应监测肾小球和肾小管功能。
