Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis
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View abstract on PubMed
Summary
This summary is machine-generated.Switching to tenofovir therapy for chronic Hepatitis B virus (HBV) infection significantly improves virological response and lowers HBV DNA levels compared to entecavir. However, benefits in HBsAg reduction or ALT normalization were not observed.
Area Of Science
- Hepatology
- Virology
- Clinical Medicine
Background
- Hepatitis B virus (HBV) infection is a major cause of liver disease and hepatocellular carcinoma.
- Effective control of viral activity is essential for managing HBV complications.
- The comparative efficacy of switching from entecavir to tenofovir for chronic HBV infection requires further clinical assessment.
Purpose Of The Study
- To assess the clinical impact of switching antiviral therapy from entecavir to tenofovir in patients with chronic Hepatitis B virus infection.
- To compare the virological and biochemical responses between tenofovir and entecavir treatments.
Main Methods
- A systematic literature search was conducted following PRISMA guidelines across major databases (Cochrane Library, PubMed, MEDLINE, Embase, Scopus).
- Studies comparing patients with HBV infection switched to tenofovir (both TDF and TAF formulations) versus those maintained on entecavir were included.
- Meta-analyses were performed using a random-effects model with RevMan 5.4, setting statistical significance at p < 0.05.
Main Results
- The meta-analysis included eight studies with 833 patients.
- Tenofovir demonstrated a significantly higher likelihood of complete virological response (RR 5.60) and greater reduction in HBV DNA levels (MD -1.03 log IU/mL) compared to entecavir (p < 0.00001 and p = 0.002, respectively).
- No significant differences were found in HBsAg reduction or HBeAg seroconversion. ALT reductions were not statistically significant overall, with entecavir showing better outcomes in subgroup analysis.
Conclusions
- Switching from entecavir to tenofovir therapy leads to improved virological response and reduced HBV DNA levels in chronic Hepatitis B virus infection.
- Tenofovir does not offer significant advantages over entecavir in terms of HBsAg reduction, HBeAg seroconversion, or overall ALT reduction.
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