Copyright ©The Author(s) 2017.
World J Hepatol. Feb 18, 2017; 9(5): 227-241
Published online Feb 18, 2017. doi: 10.4254/wjh.v9.i5.227
Table 1 Characteristics of approved oral antiviral drugs for chronic hepatitis B treatment
NAs (approval year)Class effectRenal effectMost common adverse eventsLaboratory monitoringRare severe adverse reactionsPregnancy categoryDetection in breastfeeding
Lamivudine (1998)Myopathy and neuropathy cases were reportedNo significant effectUpper respiratory tract infection, nasopharyngitis, headache and fatigue ALT flairs CK elevation may occur (usually not requiring cessation of drug)Serum ALT and bilirubinRhabdomyolysis, acute dystonia, pancreatitis Rare lactic acidosisCYes
Telbivudine (2006)Myopathy and neuropathy cases were reported (especially in combination with Peg- IFN)Nephroprotective effect Increase in GFRUpper respiratory tract infection, nasopharyngitis, headache and fatigue Increased incidence of CK elevation (usually asymptomatic and self-limiting, not required cessation of drug)CK level Serum lactateLactic acidosisBYes
Adefovir (2002)Very rare, No increased incidence of myopathy compared to placeboClinically significant nephrotoxicity Decrease in GFRPharyngitis, asteni, headache, abdominal pain, flu-like symptoms and nauseaSerum creatinine and phosphate levelHypophosphatemia Fanconi syndromeCUnknown, not recommend for use
Entecavir (2005)Very rare, No increased incidence of mitochondrial toxicity in combination of entecavir with other NAs and IFNNo decrease in GFRHeadache, upper respiratory tract infection, cough, nasopharyngitis, fatigue, dizziness, upper abdominal pain and nauseaSerum lactateLactic acidosisCUnknown, not recommend for use
Tenofovir (2008)Very rare, No increased incidence of myopathy compared to placeboMay decrease GFR, clinically insignificant Nephrotoxic in HIV patients HypophosphatemiaHeadache, nasopharyngitis, back pain, nausea Bone mineral density loss (more prominent in HIV patients)Serum creatinine and phosphate level BMDBYes