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La terapia antiviral reduce la dislipidemia y el riesgo cardiovascular en la hepatitis B crónica: el TDF es el agente

Hyuk Kim1, Jae-Young Kim2, Hyun Bin Choi1

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

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|September 4, 2025
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Resumen

La terapia antiviral para la hepatitis B crónica (CHB) reduce significativamente el riesgo de dislipidemia y de eventos cardiovasculares adversos mayores (MACE). El fumarato de tenofovir disoproxil (TDF) ofrece la protección más sustancial, destacando los beneficios extrahepáticos más allá de la supresión viral.

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Área de la Ciencia:

  • Hepatología
  • Cardiología
  • Síndrome metabólico

Sus antecedentes:

  • La hepatitis B crónica requiere tratamiento antiviral a largo plazo.
  • No se comprende completamente el impacto de la terapia antiviral con CHB en la salud metabólica y cardiovascular.

Objetivo del estudio:

  • Investigar los efectos de la terapia antiviral en la dislipidemia y los eventos adversos cardiovasculares mayores (EACM) en pacientes con EHC.
  • Evaluar los beneficios específicos del fumarato de tenofovir disoproxilo (TDF).

Principales métodos:

  • Estudio de cohorte retrospectivo a nivel nacional utilizando datos de la revisión y evaluación del seguro de salud coreano.
  • Coincidencia de la puntuación de propensión entre 48.606 pacientes tratados con CHB y controles no tratados.
  • Análisis de las tasas de incidencia y de los ratios de riesgo para la dislipidemia y la EMA.

Principales resultados:

  • La terapia antiviral redujo significativamente las tasas de incidencia de dislipidemia (IRR: 0,80) y de MACE (IRR: 0,78).
  • El fumarato de tenofovir disoproxil (TDF) demostró los efectos protectores más fuertes (aHR: 0,52 para la dislipidemia, 0,58 para el MACE).
  • Los efectos protectores fueron más pronunciados en pacientes no diabéticos.

Conclusiones:

  • La terapia antiviral para CHB ofrece beneficios extrahepáticos significativos, incluido el riesgo reducido de dislipidemia y MACE.
  • El TDF es particularmente eficaz para mitigar estos riesgos.
  • Estos hallazgos apoyan el uso de la terapia antiviral en el tratamiento integral a largo plazo de la EHC.