Tenofovir-induced Fanconi syndrome in a patient with chronic hepatitis B monoinfection

• Published in: Annals of hepatology Vol. 15; no. 2; pp. 273 - 276
• Main Authors: Conti, Fabio, Vitale, Giovanni, Cursaro, Carmela, Bernardi, Mauro, Andreone, Pietro
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier 01-03-2016
• Subjects: Antiviral Agents - adverse effects; Deprescriptions; Fanconi Syndrome - chemically induced; Gastroenterology and Hepatology; Glomerular Filtration Rate; Guanine - analogs & derivatives; Guanine - therapeutic use; Hepatitis B virus; Hepatitis B, Chronic - drug therapy; Humans; Male; Middle Aged; Nephropathy; Recovery of Function; Renal toxicity; Tenofovir - adverse effects; Nephropathy; Hepatitis B virus; Renal toxicity
• ISSN: 1665-2681
• DOI: 10.5604/16652681.1193725

AbstractTenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor indicated for treatment of patients with chronic hepatitis B virus (CHB) and human immunodeficiency virus (HIV) infections. Despite the good safety profile of the drug, Fanconi syndrome is a possible adverse reaction of TDF treatment, especially in HIV-infected patients. Only a few cases have been reported in patients with CHB-monoinfections. This report presents a case of a 58-year-old man with mild HBeAg-negative CHB who was exposed to TDF and developed drug-induced Fanconi syndrome. Renal dysfunction reverted after TDF discontinuation and a switch to entecavir, and viral replication remained suppressed. A literature review yielded six additional cases of TDF-induced Fanconi syndrome, all with risk factors for renal dysfunction despite the patients having normal glomerular filtration rates. We discuss the overall risk for Fanconi syndrome in CHB-monoinfected patients exposed to TDF and the importance of careful monitoring of glomerular and tubular functions even when pre-existing kidney disease is not present.