The efficacy and safety analysis of entecavir, tenofovir disoproxil fumarate, and tenofovir alafenamide fumarate in the treatment of chronic hepatitis B
CHENG Jiaxi
WANG Wandang
SHI Meibin
HUANG Xiangya
YANG Jie
LI Qiaoshan
ZOU Qiming
LI Juan
Abstract：Objective To observe the clinical efficacy and safety entecavir ( ETV ), tenofovir disoproxil fumarate ( TDF ), tenofovir alafenamide fumarate ( TAF ) in antiviral treatment of chronic hepatitis B. Methods From March 2021 to June 2023, 181 patients with chronic hepatitis B admitted to our hospital were grouped into 3 groups according to different antiviral drugs. Sixty-six patients in the ETV group only took ETV, 64 patients in the TDF group only took TDF, and 51 patients in the TAF group only took TAF. Blood lipids, liver function, hepatitis B virus surface antigen ( HBsAg ), hepatitis B virus deoxyribonucleic acid ( HBV DNA ), blood creatinine, and estimated glomerular filtration rate ( eGFR ) were compared. Results The effective rate was 86.36％ ( 57/66 ) in the ETV group, 90.63％ ( 58/64 ) in the TDF group, and 90.20％ ( 46/51 ) in the TAF group. There was no significant difference among the 3 groups ( P >0.05 ). After treatment, HBsAg level and HBV DNA load in the 3 groups were lower than those before treatment ( P <0.05 ), and the changes in HBsAg level and HBV DNA load among the 3 groups were statistically significant ( P <0.05 ). After treatment, the levels of ALT and AST in the 3 groups were lower than those before treatment (P <0.05), and the changes of ALT and AST levels among the 3 groups were statistically significant ( P <0.05 ). After treatment, HDL-C and LDL-C in ETV group were higher than those before treatment ( P <0.05 ), and there was no significant difference in TC and TG ( P >0.05 ). TC and HDL-C in TDF group were significantly lower than those before treatment ( P <0.05 ), TG and LDL-C were not significantly different from those before treatment ( P >0.05 ). There were no significant differences in TC, TG, HDL-C and LDL-C in the TAF group compared with those before treatment ( P>0.05 ), but there were significant differences in the changes of TC, TG, HDL-C and LDL-C among the 3 groups (P <0.05 ). After treatment, there were no significant differences in serum creatinine and eGFR among the 3 groups ( P>0.05 ), but there were significant differences in the changes of serum creatinine and eGFR among the three groups ( P <0.05 ). Conclusions The clinical efficacy of ETV, TDF and TAF in the treatment of chronic hepatitis B is similar. Taking TAF will not affect blood lipids, but taking ETV will increase HDL-C and LDL-C, and taking TDF can reduce TC and HDL-C, and all have good renal safety.
Keywords：nucleoside analogues and nucleotide analoguesantiviruschronic hepatitis Bblood fatentecavirtenofovir disoproxil fumaratetenofovir alafenamide fumarate
Publication Date：2024-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 11-15 )