Low Dose TDF for chronic Hep B

General Discussion
1

Hello everyone, hope everything is well.
I really appreciate everyone here that make this site possible. I have gotten so much great information on here, so thank you !!

Here is my question about TDF, I am in the States and TAF is around $1500 a month and TDF is S30 a month. so my insurance has denied my request for TAF.

My viral load is low and became undetected after taking lower doses of TDF for 3months. My kidney function remains in the normal range.

I am taking TDF $300 mg on Tuesday, Thurday, and Sunday., And 150mg on MWFS.
My reason of doing this is because I am in my early 50s and want to preserve my Kidney function. and because my starting viral load is low.

I have scrub the internet for studies on lower dose of TDF and there isn’t much. For one I did not see any bad outcomes when TDF dose is reduced. And there was one study found kidney function was affected more in thin Japanese men. I am Asian and also thin. There is also a recommendation for every other day dosing for those with existing kidney disease. So I decided to reduce my TDF dosing on my own. I also saw a very small study where the dose was cut in half and there was sufficient viral suppression.

I also read something about consideration of reducing the dose in places where TDF availability is limited, so more people can be treated.

Does any one here have experience on long term lower dose TDF? For now I will monitor my titer and viral load closely , every 3 months and if I remain undetectable, I will remain on the low dose.

Thanks everyone , any thoughts on this? @availlant

2

Hi @LiveWell,

While there is a moderatrly elevated risk of altered kidney function with TDF, this does not affect the majority of patients and only becomes clinically significant in a smaller proportion of patients. Risk is however related to length of exposure. In any case, changes in kidney function would be caught early during your regular follow-ups with your doctor. In these cases 300mg TDF dosing can be switched from every day to every other day which reverses kidney dysfunction without impacting antiviral effects.

@availlant

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Thank You! @Availlant

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Hi @LiveWell,
May I ask why you are taking these decisions without any guidance from your doctor? At least that is my understanding of your post that you are making these decisions yourself. Correct me if I am wrong. I understand your concern about kidney problems, but I think it might serve you well to work with a provider that treats and understands this disease. Rather than taking this big decision by yourself without any guidance. Just my thought. Best, Bansah1

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Yes, very much agree with @Bansah1. Altering the dosage levels of your medication can be risky and you definitely should involve your health care provider in these decisions.

If there is no indication of any side-effects, there is no necessity to alter your dosage.

Cheers,
Thomas

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Thanks @ThomasTu, I will be more careful.

Cheers!

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