Real-life data of tenofovir disoproxil fumarate and tenofovir alafenamide fumarate in the patients with chronic hepatitis B: a single-center experience

Authors : Mustafa Akar

Pages : 239-245

Doi:10.38053/acmj.951923

View : 20 | Download : 14

Publication Date : 2021-07-14

Article Type : Research

Abstract :Background & Aims: Chronic hepatitis B (CHB) infection can cause liver cirrhosis and hepatocellular carcinoma. In this study, it was aimed to evaluate the efficacy of tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide fumarate (TAF) on clinical parameters, glomerular filtration rate (GFR), and phosphorus metabolism in the patients with CHB. Materials and Methods: Eighty-one patients with CHB treated with TDF were included in the study. 27 of them switched from TDF to TAF during the follow-up was considered as TAF group. 54 patients continued TDF were evaluated as TDF group. Demographic, clinical, and laboratory data of the patients were obtained from outpatient follow-up files. Results: The mean ages of the patients were 45±12 and 48±15 in the TDF and TAF groups, respectively. The mean durations of TDF treatment were 31±20 and 52±32 months, respectively. The mean duration of TDF use was significantly higher in the TAF group (0.01). The mean aspartate aminotransferase (AST), alanine aminotransferase (ALT), GFR, and serum phosphorus levels of the patients before/after the TDF treatment were 48/23 U/L, 67/25 U/L, 99/103 ml/min, and 2.9/3.1 mg/dl in the TDF group, respectively. The mean AST, ALT, GFR, and serum phosphorus levels of the patients before the TDF treatment/at the time of the switch/after the TAF treatment were 42/22/21 U/L, 48/23/22 U/L, 90/100/102 ml/min, and 2.8/2.3/2.9 mg/dl in the TAF group, respectively. Decrease in the mean values of the transaminases after the TDF treatment in the both groups and increase in the mean level of phosphorus after the switching were found significant (p <0.05). There was no significant change in GFR values under the TDF treatment in the TDF group. But, a significant increase in GFR levels was seen after the switch in the TAF group (p<0.05). In addition, the mean GFR values of 3 patients switched due to low GFR showed a significant decrease under the TDF treatment and a significant increase after the TAF treatment. A significant improvement was observed in the total hip and spine T score of 2 patients who were switched to TAF due to osteoporosis. While detectable HBV DNA was detected in 2 (7%) patients under TDF treatment, this was not observed in any patient after switching to TAF treatment. Conclusions: TAF used in the treatment of chronic hepatitis B has a similar efficacy with TDF, and it has more positive effects on creatinine clearance, bone mineral density, and phosphorus metabolism than TDF.
Keywords : Chronic hepatitis B, hypophosphatemia, osteoporosis, tenofovir disoproxil fumarate, tenofovir alafenamide fumarate