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Antiviral Therapy Reduces Dyslipidemia and Cardiovascular Risk in Chronic Hepatitis B: TDF as the Most Effective

Hyuk Kim1, Jae-Young Kim2, Hyun Bin Choi1

  • 1Department of Internal Medicine, Division of Gastroenterology and Hepatology, Soonchunhyang University Bucheon Hospital, Bucheon-si, Korea.

Journal of Medical Virology
|September 4, 2025
PubMed

Insights

Antiviral therapy for chronic hepatitis B (CHB) significantly reduces the risk of dyslipidemia and major adverse cardiovascular events (MACE). Tenofovir disoproxil fumarate (TDF) offers the most substantial protection, highlighting extrahepatic benefits beyond viral suppression.

Area of Science:

  • Hepatology
  • Cardiology
  • Metabolic Syndrome

Background:

  • Chronic hepatitis B (CHB) necessitates long-term antiviral treatment.
  • The impact of CHB antiviral therapy on metabolic and cardiovascular health is not fully understood.

Purpose of the Study:

  • To investigate the effects of antiviral therapy on dyslipidemia and major adverse cardiovascular events (MACE) in CHB patients.
  • To assess the specific benefits of tenofovir disoproxil fumarate (TDF).

Main Methods:

  • Nationwide retrospective cohort study using Korean Health Insurance Review and Assessment data.
  • Propensity score matching of 48,606 treated CHB patients with untreated controls.
  • Analysis of incidence rates and hazard ratios for dyslipidemia and MACE.

Main Results:

  • Antiviral therapy significantly lowered incidence rates of dyslipidemia (IRR: 0.80) and MACE (IRR: 0.78).
  • Tenofovir disoproxil fumarate (TDF) demonstrated the strongest protective effects (aHR: 0.52 for dyslipidemia, 0.58 for MACE).
  • Protective effects were more pronounced in non-diabetic patients.

Conclusions:

  • Antiviral therapy for CHB offers significant extrahepatic benefits, including reduced risk of dyslipidemia and MACE.
  • TDF is particularly effective in mitigating these risks.
  • These findings support the use of antiviral therapy in comprehensive long-term CHB management.

Keywords:
antiviral agentsdyslipidemiahealth insurancemajor adverse cardiac events

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