Evaluation of bone turn over markers in patients with chronic hepatitis B infection and under Tenofovit treatment

Aim: Bone health depends on renal function and active bone metabolism in chronic hepatitis B (CHB). Differences of serum levels of bone turnover markers were studied in patients with active and inactive CHB. Markers were compared at baseline and after 3 months of treatment with tenofovir (TDF). Materials and methods: Twenty-five patients with active CHB and indication for antiviral treatment with TDF according to current guidelines for management of CHB and 34 patients with inactive CHB were investigated. Serum levels of osteocalcin (OC), fibroblast growth factor 23 and C-terminal telopeptide of type I collagen (CTX), 25-hydroxy-vitamin D (25(OH)-D), osteoprotegerin (OPG), propeptide of type 1 procollagen (P1NP), and the glomerular filtration rate (GFR) were measured at baseline and after 3 months of TDF. Results: At baseline, patients with active CHB showed a significantly lower level of 25(OH)-D (23.2 ± 10.2 vs. 25.8 ± 13.0 ng/ml; p= 0.03) and a significantly lower GFR (87.0 ± 16.7 vs. 91.1 ± 19.7 ml/min; p= 0.01) when compared to those with inactive CHB. The mean OPG level was found to be significantly higher in patients with active CHB (5.6 ± 3.9 vs. 4.7 ± 2.2 pmol/l; p= 0.03). When baseline levels and those determined after 3 months of treatment with TDF were compared, a significant increase of the mean OC level (18.1 ± 9.5 vs. 23.0 ± 8.7 ng/ml; p = 0.048) was observed in patients with active CHB. Conclusions: The results of this study indicate that the activity of HBV infection may influence bone metabolism and renal function. After 3 months of treatment with TDF, OC appears to be the only osteological marker with a significant change in active CHB. These data suggest possible beneficial effects of osteoprotective treatment in active CHB independent of antiviral treatment with TDF.