scholarly journals Real-world experience of switching from tenofovir disoproxil fumarate to tenofovir alafenamide in patients with chronic hepatitis B: a retrospective study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12527
Author(s):  
Pei-Yuan Su ◽  
Wei-Wen Su ◽  
Yu-Chun Hsu ◽  
Siou-Ping Huang ◽  
Hsu-Heng Yen
Keyword(s):  
Body Mass Index ◽  
Renal Function ◽  
Body Weight ◽  
Chronic Hepatitis ◽  
Retrospective Study ◽  
Hepatitis B ◽  
Real World ◽  
Viral Suppression ◽  
The Body ◽  
Tenofovir Alafenamide

Background Tenofovir alafenamide (TAF) has good viral suppression efficacy and less adverse effect than tenofovir disoproxil fumarate (TDF). Real-world studies on the antiviral efficacy and safety of switching from TDF to TAF in patients with chronic hepatitis B (CHB) are limited. Methods This retrospective study included 167 nucleos(t)ide analogue (NA)-naive patients with CHB. All the patients received TDF at least 12 months before switching and TAF at least 12 months after switching at a single medical center. The Friedman test with Dunn–Bonferroni post hoc tests and repeated-measures analysis of variance was used to analyze the effect of complete viral suppression, alanine aminotransferase (ALT) level normalization, renal function changes, body weight, and body mass index in the periods before and after switching. Results The mean age and TDF treatment duration were 52 ± 11 years and 2.8 years (interquartile range, 1.51–5.15 years), respectively. The complete viral suppression rate was similar between the time of switching and 48 weeks after switching to TAF (77.8% vs 76%, P = 1.000). The percentage of alanine aminotransferase (ALT) normalization increased from 26.3% at TDF start to 81.4% (P < 0.001) at time of switching and 89.2% at 48 weeks after switching to TAF (P = 0.428). The median estimated glomerular filtration rate decreased from 100.09 mL/min/1.73 m² at TDF start to 91.97 mL/min/1.73 m² (P < 0.001) at the time of switching and stabilized at 48 weeks after switching to TAF (93.47 mL/min/1.73m², P = 1.000). The body weight decreased from 69.2 ± 12.2 kg at TDF start to 67.4 ± 12.1 kg (P < 0.001) at the time of switching to TAF and returned to 68.7 ± 12.7 kg (P < 0.001) 48 weeks thereafter. The body mass index (BMI) decreased from 25 ± 3.3 kg/m² at TDF start to 24.5 ± 3.3 kg/m² (P = 0.002) at the time of switching to TAF and returned to 25.1 ± 3.6 kg/m² (P < 0.001) 48 weeks thereafter. Conclusions Our study showed that switching to TAF from TDF had good antiviral effectiveness and stabilized renal function. The body weight and BMI decreased during TDF therapy and regained after switching to TAF.

Longitudinal Change of Body Mass Index Is Associated With Alanine Aminotransferase Elevation After Complete Viral Suppression in Chronic Hepatitis B Patients

2019 ◽  
Vol 220 (9) ◽  
pp. 1469-1476 ◽  
Author(s):  
Kaifeng Wang ◽  
Weiyin Lin ◽  
Zhe Kuang ◽  
Rong Fan ◽  
Xieer Liang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Body Mass ◽  
Alanine Aminotransferase ◽  
Viral Suppression ◽  
Low Bmi ◽  
High Bmi

Abstract Background Little is known about cause and intervention for alanine aminotransferase (ALT) elevation after complete viral suppression in patients with chronic hepatitis B (CHB). Methods In this prospective cohort study, patients with CHB who were treated with nucleos(t)ide analogs and maintained undetectable levels of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) for at least 6 months were enrolled. Patients were followed up at 6-month intervals, and anthropometric, biochemical, and virological assessments were performed. Results Of 1965 patients with median follow-up of 18.36 months, one third of patients experienced ALT elevation. Baseline high body mass index ([BMI] defined as ≥25 kg/m2), younger age, and liver cirrhosis independently increased the risk of longitudinal ALT elevation. At the end of follow-up, 89 (4.8%) patients reverted to low BMI, and 92 (5.0%) developed to high BMI. Compared with persistent high BMI, reversion to low BMI reduced the risk of ALT elevation (adjusted odds ratio [aOR], 0.38; 95% confidence interval [CI], 0.19–0.77); compared with persistent low BMI, onset of high BMI increased the risk of ALT elevation (aOR, 1.78; 95% CI, 1.02–3.11). Conclusions High BMI is an independent predictor for ALT elevation after complete HBV DNA suppression. Improvement of BMI may have a beneficial effect on ALT normalization and even long-term outcomes.

Real-world experience from tenofovir alafenamide use in chronic hepatitis B: an Hellenic multicenter real-life clinical study (HERACLIS-TAF)

2020 ◽  
Vol 73 ◽  
pp. S865-S866
Author(s):  
George Papatheodoridis ◽  
Konstantinos Mimidis ◽  
Spilios Manolakopoulos ◽  
Nikolaos Gatselis ◽  
Ioannis Goulis ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Clinical Study ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Real World ◽  
Real Life ◽  
Tenofovir Alafenamide

Real World Experience of Prescribing Tenofovir Alafenamide for Chronic Hepatitis B Patients in Germany

2019 ◽  
Author(s):  
J Petersen ◽  
C Hoffmann ◽  
A Rieke ◽  
M Cornberg ◽  
H Hinrichsen ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Real World ◽  
Tenofovir Alafenamide

FRI-170-Real-world effectiveness and renal safety of tenofovir alafenamide fumarate among chronic hepatitis B patients in Canada

2019 ◽  
Vol 70 (1) ◽  
pp. e463-e464
Author(s):  
Mina Farag ◽  
Scott Fung ◽  
Edward Tam ◽  
Karen Doucette ◽  
Alexander Wong ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Real World ◽  
Tenofovir Alafenamide ◽  
Renal Safety

scholarly journals Long-term efficacy and safety of nucleos(t)ides analogues in patients with chronic hepatitis B

2021 ◽  
Vol 8 ◽  
pp. 204993612098595
Author(s):  
Luisa Roade ◽  
Mar Riveiro-Barciela ◽  
Rafael Esteban ◽  
Maria Buti
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Viral Suppression ◽  
Therapeutic Option ◽  
Hepatitis B Surface Antigen ◽  
Antiviral Treatment ◽  
B Virus ◽  
Treatment Switch ◽  
Tenofovir Alafenamide

Nucleos(t)ide analogues with high barrier to resistance are regarded as the principal therapeutic option for chronic hepatitis B (CHB). Treatment with entecavir (ETV), tenofovir disoproxil (TDF) and the later released tenofovir alafenamide (TAF) is highly effective at controlling hepatitis B virus (HBV) infection and, in the vast majority of patients, is well tolerated. No significant differences in viral suppression have been described among the different regimens, although an earlier achievement in biochemical response has been suggested first under TDF and recently under TAF. High barrier to resistance NAs rarely achieve hepatitis B surface antigen sero-clearance, and therefore should be maintained life-long in most cases. This has increased concerns about treatment-related toxicity, especially in patients under TDF with additional risk factors for kidney and bone impairment. TAF has shown a better bone and kidney safety profile than TDF, although it is not yet available worldwide due to its higher cost. Emergence of adverse events should be monitored since treatment-switch to ETV/TAF seems to be effective and safe in HBV mono-infected subjects. Finally, although an effective antiviral treatment leads to a clear improvement in clinical outcome of CHB patients; the risk of developing hepatocellular carcinoma (HCC) is not completely avoided with viral suppression. Whether tenofovir-based regimens provide any additional benefit over ETV in HCC prevention remains unclear and requires further investigation.

scholarly journals Real-World Single-Center Comparison of the Safety and Efficacy of Entecavir, Tenofovir Disoproxil Fumarate, and Tenofovir Alafenamide in Patients with Chronic Hepatitis B

Intervirology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Sara Jeong ◽  
Hyun Phil Shin ◽  
Ha Il Kim
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Real World ◽  
Tenofovir Disoproxil Fumarate ◽  
Antiviral Effect ◽  
Incidence Rates ◽  
Duration Of Treatment ◽  
Significant Difference ◽  
Tenofovir Alafenamide

<b><i>Introduction:</i></b> Chronic hepatitis B (CHB) is a major cause of chronic liver diseases and tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), and entecavir (ETV) are recommended as primary treatments. This study aimed to evaluate the efficacy and safety of ETV, TDF, and TAF in a real-world clinical setting. <b><i>Methods:</i></b> In this retrospective cohort study, a total of 363 CHB patients who were treated with ETV (<i>n</i> = 163), TDF (<i>n</i> = 154), or TAF (<i>n</i> = 46) from July 2007 to September 2019 were enrolled. <b><i>Results:</i></b> Median patient age was 51 years and 66.4% of patients were male. Median duration of treatment with ETV, TDF, or TAF was 49.0 months (interquartile range, 27.0–74.0 months). In terms of safety, cholesterol was mildly increased in the ETV and TAF groups and significantly lowered in the TDF group than baseline (<i>p</i> &#x3c; 0.001). There was no significant difference in liver cirrhosis-related complications among the 3 groups at 48 weeks (<i>p</i> = 0.235). Hepatitis B e antigen seroconversion, complete virological response, and alanine aminotransferase normalization at 48 weeks as measures of treatment efficacy were not significantly different among the 3 groups (<i>p</i> = 0.142, 0.538, and 0.520, respectively). There was also no significant difference in cumulative incidence rate of hepatocellular carcinoma (HCC) between the ETV and TDF groups (<i>p</i> = 0.894). <b><i>Conclusions:</i></b> ETV, TDF, and TAF were safe antiviral agents and showed similar antiviral effect for CHB at 48 weeks. Cirrhosis-related complications and annual HCC incidence rates did not differ significantly between the ETV and TDF groups over the 48 week follow-up period.

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