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

Manas K Behera1, Girish K Pati1, Jimmy Narayan1

  • 1Department of Gastroenterology, IMS and SUM Hospital, Siksha "O" Anusandhan (Deemed to Be University), K8, Kalinga Nagar, Bhubaneswar, 751003, Odisha, India.

Journal of Clinical and Experimental Hepatology
|March 8, 2021
PubMed

Insights

Tenofovir disoproxil fumarate (TDF) demonstrated superior viral suppression compared to Entecavir (ETV) in HBeAg-positive Chronic Hepatitis B patients. This finding is significant for nucleos(t)ide-naïve individuals undergoing antiviral therapy.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Chronic Hepatitis B (CHB) affects 400 million globally.
  • Tenofovir disoproxil fumarate (TDF) and Entecavir (ETV) are first-line treatments.
  • Limited Indian data compares TDF and ETV efficacy in CHB.

Purpose of the Study:

  • To compare the efficacy of ETV and TDF in nucleos(t)ide-naïve CHB patients.
  • To evaluate viral suppression rates over 24 months.
  • To assess treatment outcomes in HBeAg-positive and HBeAg-negative CHB cases.

Main Methods:

  • Retrospective cohort study of 192 treatment-naïve CHB patients.
  • Patients received either TDF or ETV for 24 months (March 2015 - August 2017).
  • Primary endpoint: undetectable hepatitis B virus DNA at 24 months.

Main Results:

  • TDF group: 38 HBeAg-positive, 53 HBeAg-negative patients.
  • ETV group: 40 HBeAg-positive, 61 HBeAg-negative patients.
  • TDF showed significantly higher viral suppression in HBeAg-positive CHB (P=0.008).
  • No significant difference in viral suppression for HBeAg-negative CHB (P=0.38).

Conclusions:

  • Tenofovir demonstrated a more effective antiviral suppressive effect than ETV.
  • This was specifically observed in HBeAg-positive, nucleos(t)ide-naïve CHB cases.
  • Treatment outcomes were similar for HBeAg-negative CHB patients.
Abstract

Keywords:
ALT, alanine aminotransferaseAPRI, AST-to-platelet Ratio IndexBMI, body mass indexCHB, chronic hepatitis BCI, confidence intervalETV, entecavirHBV, hepatitis B virusHBVDNA, hepatitis B DNAHBeAg, hepatitis B e antigenHBsAg, hepatitis B surface antigenHCC, hepatocellular carcinomaHCV, hepatitis C virusHIV, human immunodeficiency virusHb, hemoglobinTDF, tenofovir disoproxil fumarateantiviral therapychronic hepatitis Bentecavirtenofovir

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