Evidence map›Paper›PMID 34174833›Full record

ArticleBMC infectious diseases2021

Hepatitis B virus (HBV) viral load, liver and renal function in adults treated with tenofovir disoproxil fumarate (TDF) vs. untreated: a retrospective longitudinal UK cohort study.

Tingyan Wang, David A Smith, Cori Campbell, Jolynne Mokaya, Oliver Freeman, Hizni Salih, Anna L McNaughton, Sarah Cripps, Kinga A Várnai, Theresa Noble and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

Tingyan WangNuffield Department of Medicine, University of Oxford, Oxford, UK.
David A SmithNational Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.
Cori CampbellNuffield Department of Medicine, University of Oxford, Oxford, UK.
Jolynne MokayaNuffield Department of Medicine, University of Oxford, Oxford, UK.
Oliver FreemanNational Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.
Hizni SalihNational Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.
Anna L McNaughtonNuffield Department of Medicine, University of Oxford, Oxford, UK.
Sarah CrippsPharmacy Department, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Kinga A VárnaiNational Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.
Theresa NobleNational Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.
Kerrie WoodsNational Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.
Jane CollierDepartment of Hepatology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Katie JefferyDepartment of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Jim DaviesNational Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.
Eleanor Barnes *Nuffield Department of Medicine, University of Oxford, Oxford, UK. ellie.barnes@ndm.ox.ac.uk.
Philippa C Matthews *Nuffield Department of Medicine, University of Oxford, Oxford, UK. philippa.matthews@ndm.ox.ac.uk.
National Institute for Health Research · GBUniversity of Oxford · GBJohn Radcliffe Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent clinical guidelines recommend treating chronic hepatitis B virus (HBV) infection in a minority of cases, but there are relatively scarce data on evolution or progression of liver inflammation and fibrosis in cases of chronic HBV (CHB) that do not meet treatment criteria. We aimed to assess the impact of TDF on liver disease, and the risk of renal impairment in treated CHB patients in comparison to untreated patients.

methodsWe studied a longitudinal ethnically diverse CHB cohort in the UK attending out-patient clinics between 2005 and 2018. We examined TDF treatment (vs. untreated) as the main exposure, with HBV DNA viral load (VL), ALT, elastography scores and eGFR as the main outcomes, using paired tests and mixed effects model for longitudinal measurements. Additionally, decline of eGFR during follow-up was quantified within individuals by thresholds based on clinical guidelines. Baseline was defined as treatment initiation for TDF group and the beginning of clinical follow-up for untreated group respectively.

resultsWe included 206 adults (60 on TDF, 146 untreated), with a median ± IQR follow-up duration of 3.3 ± 2.8 years. The TDF group was significantly older (median age 39 vs. 35 years, p = 0.004) and more likely to be male (63% vs. 47%, p = 0.04) compared to the untreated group. Baseline difference between TDF and untreated groups reflected treatment eligibility criteria. As expected, VL and ALT declined significantly over time in TDF-treated patients. Elastography scores normalised during treatment in the TDF group reflecting regression of inflammation and/or fibrosis. However, 6/81 (7.4%) of untreated patients had a progression of fibrosis stage from F0-F1 to F2 or F3. There was no evidence of difference in rates or incidence of renal impairment during follow-up in the TDF vs. untreated group.

conclusionsRisk of liver inflammation and fibrosis may be raised in untreated patients compared to those receiving TDF, and TDF may benefit a larger percentage of the CHB population.

Indexed as

AdultAgedAged, 80 and overAntiviral AgentsCohort StudiesElasticity Imaging TechniquesFemaleHepatitis BHepatitis B, ChronicHepatitis B e AntigensHepatitis B virusHumansKidneyLiverLongitudinal StudiesMaleAntiviral AgentsHepatitis B e AntigensTenofovirChronic hepatitis BeGFRLiver fibrosisRenal impairmentTenofovir Disoproxil fumarate (TDF) therapy

Identifiers

PMID34174833
PMCPMC8235844
OpenAlexW3176081318

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.