Effects of tenofovir alafenamide and entecavir on fibrosis markers,liver stiffness,and cytokine profiles in pa-tients with hepatitis B virus-related cirrhosis
ZHAO Yun
XU Fang
SHENG Fang
WANG Chen
Abstract：Objective To investigate the effects of tenofovir alafenamide(TAF)and entecavir(ETV)on fibrosis markers,liver stiffness,and cytokine expression profiles in patients with hepatitis B virus(HBV)-related cirrhosis,ai-ming to identify the more favorable antiviral drug for treatment-naïve patients.Methods Ninety patients with HBV-related cirrhosis admitted to our hospital between January 2021 and July 2023 were enrolled and divided into a TAF group(n=39)and an ETV group(n=51)according to their antiviral regimen.All patients received compound glycyrrhizin to improve liver function in addition to either ETV or TAF.Continuous treatment and follow-up lasted at least 12 months.Liver function parameters[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)],fibrosis markers[hyaluronic acid(HA),laminin(LN),type Ⅲ procollagen N-terminal peptide(PⅢ-NP),type Ⅳcollagen(Ⅳ-C)],liver stiffness,and serum cytokines[interleukin(IL)-2,IL-4,IL-6,IL-8,IL-10,tumor necrosis factor(TNF)-α]were assessed at baseline and at 3,6,9,and 12 months of treatment.HBV DNA clearance rates and adverse events were also evaluated.Results Both groups showed significant reductions in TBIL,ALT,and AST after 3-12 months of treatment compared with baseline(P＜0.05),with no significant between-group differences at each time point(P＞0.05).Levels of HA,LN,P Ⅲ-NP,Ⅳ-C,liver stiffness,IL-2,IL-6,IL-8,and TNF-α decreased significantly,while IL-4 and IL-10 increased significantly after treatment in both groups(P＜0.05).At 3 and 6 months,reductions in fibrosis markers,liver stiffness,and pro-inflammatory cytokines,as well as increases in anti-inflammatory cytokines,were more pronounced in the TAF group compared with the ETV group(P＜0.05),whereas no significant differences were observed at 9 and 12 months(P＞0.05).HBV DNA clearance rates were consist-ently higher in the TAF group than in the ETV group during follow-up,though the differences were not statistically signif-icant(P＞0.05).The incidence of adverse events was significantly lower in the TAF group(P＜0.05).Conclusion Compared with ETV,TAF leads to more rapid reductions in inflammatory cytokines and fibrosis markers in patients with HBV-related cirrhosis,suggesting that TAF may have greater clinical value in this population.
Keywords：HBV-induced cirrhosistenofovir alafenamide fumarateentecavirliver fibrosis indicatorsliver stiffness
Publication Date：2025-12-15
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：7( 1864-1870 )