Liver Centre, Toronto Western Hospital, University Health Network / University of Toronto. Toronto, Ontario, Canada.
Therap Adv Gastroenterol. 2010 Mar;3(2):107-19. doi: 10.1177/1756283X09354562.
Chronic hepatitis B (CHB) is prevalent worldwide. It may cause cirrhosis and hepatocellular carcinoma. Treatment for this condition may need to be lifelong, thus the drugs used must be both efficacious and safe. Clinical trials of tenofovir have demonstrated a good safety profile for this drug and it has potent antiviral properties. However, to better characterize the safety of this drug, the postmarketing surveillance must be taken into account. Clinicians need to be vigilant, as infrequent adverse events may be revealed during this phase. The current review presents a detailed exposé of preclinical and clinical data on tenofovir to increase awareness of possible adverse events and drug-drug interactions, based on the large experience of this drug in human immunodeficiency virus (HIV) treatment (and to date in patients with CHB). Several recommendations that may help the clinician to prevent the development of adverse events associated with tenofovir disoproxil fumarate (TDF) treatment are outlined, along with a suggested surveillance protocol for the timely and proper identification of possible renal and bone toxicity.
慢性乙型肝炎（CHB）在全球范围内普遍存在。它可能导致肝硬化和肝细胞癌。这种疾病的治疗可能需要终身进行，因此所用药物必须既有效又安全。替诺福韦的临床试验已经证明了这种药物良好的安全性，并且具有很强的抗病毒作用。然而，为了更好地描述这种药物的安全性，必须考虑上市后监测。临床医生需要保持警惕，因为在这个阶段可能会发现罕见的不良反应。目前的综述详细介绍了替诺福韦的临床前和临床数据，以提高对可能的不良反应和药物相互作用的认识，这是基于该药物在人类免疫缺陷病毒（HIV）治疗中的大量经验（迄今为止，在 CHB 患者中也有应用）。概述了一些建议，这些建议可能有助于临床医生预防与富马酸替诺福韦二吡呋酯（TDF）治疗相关的不良反应的发生，并提出了一个建议的监测方案，以便及时和恰当地识别可能的肾毒性和骨毒性。
