Tenofovir is Superior to Entecavir in Patients with Treatment-naïve Hepatitis B e-Antigen-Positive Chronic Hepatitis B - PubMed (original) (raw)

Tenofovir is Superior to Entecavir in Patients with Treatment-naïve Hepatitis B e-Antigen-Positive Chronic Hepatitis B

Manas K Behera et al. J Clin Exp Hepatol. 2021 Jan-Feb.

Abstract

Background and aim: Chronic Hepatitis B (CHB) is a global health problem affecting around 400 million of people worldwide. Two available first-line antiviral drugs are tenofovir disoproxil fumarate (TDF) and Entecavir (ETV). Till date,there are few published reports from India comparing efficacy of TDF and ETV in CHB cases. Therefore, this present study was carried out with an aim to compare the efficacy of ETV and TDF in patients with nucleos(t)ide naïve CHB.

Materials and methods: This retrospective cohort study was carried out in 192 treatment naïve CHB cases, who completed 24 months of treatment with either TDF or ETV between March 2015 and August 2017. The primary end point of the study was undetectable hepatitis B virus DNA after 24 months of therapy.

Results: Of total 192 patients with CHB, 38 hepatitis B e-antigen (HBeAg)-positive and 53 HBeAg-negative patients were treated with tenofovir, whereas 40 HBeAg-positive and 61 HBeAg-negative patients were treated with ETV. Pretreatment characteristics at baseline were not statistically different between the TDF and ETV groups. Patients treated with TDF achieved significantly higher complete viral suppression as compared with ETV-treated patients (Log rank: 7.04, P = 0.008) in HBeAg-positive CHB during the 24 months follow-up time; whereas no significant difference in viral suppression rate could be noticed in HBeAg-negative patients (Log rank: 0.98, P = 0.38). Both univariate and multivariate analysis by cox proportional hazard model confirmed that tenofovir had significant rate of complete viral suppression in comparison with ETV in HBeAg-positive patients (P < 0.05); whereas complete viral suppression rates were similar in HBeAg-negative patients.

Conclusion: In our study, tenofovir had more effective antiviral suppressive effect compared with ETV in HBeAg-positive, nucleos(t)ide-naïve CHB cases.

Keywords: ALT, alanine aminotransferase; APRI, AST-to-platelet Ratio Index; BMI, body mass index; CHB, chronic hepatitis B; CI, confidence interval; ETV, entecavir; HBV, hepatitis B virus; HBVDNA, hepatitis B DNA; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HIV, human immunodeficiency virus; Hb, hemoglobin; TDF, tenofovir disoproxil fumarate; antiviral therapy; chronic hepatitis B; entecavir; tenofovir.

© 2020 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.

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Figures

Figure 1

Figure 1

Flow diagram of patients enrolled in the study. HBsAg,hepatitis B surface antigen; HBVDNA,hepatitis B DNA; HBeAg, hepatitis B e antigen; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HIV, human immunodeficiency virus; TDF, tenofovir disoproxil fumarate; ETV, entecavir.

Figure 2

Figure 2

Kaplan-Meir survival analysis showed that probability of undetectable HBV DNA was higher with TDF than ETV in HBeAg-positive patients. ETV, entecavir; TDF, tenofovir disoproxil fumarate; HBVDNA,hepatitis B virus DNA.

Figure 3

Figure 3

Kaplan Meir survival analysis showed that probablity of undetectable HBV DNA was similar with TDF and ETV in HBeAg Negative patients. Abreviations:ETV,Entecavir;TDF,Tenofovir;HBVDNA,Hepatitis B Virus DNA

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