Efficacy and safety of tenofovir alafenamide fumarate in nucleoside analogue treatment-naïve patients with chronic hepatitis B

Chen,Peng; Wei,Wei; Jin,Li; Kuai,Wentao; Li,Fei; Liu,Huan; Jiang,Bei; Zhu,Yu

doi:10.3892/etm.2021.10760

Efficacy and safety of tenofovir alafenamide fumarate in nucleoside analogue treatment-naïve patients with chronic hepatitis B

Authors:
- Peng Chen
- Wei Wei
- Li Jin
- Wentao Kuai
- Fei Li
- Huan Liu
- Bei Jiang
- Yu Zhu
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Affiliations: Department of Chronic Liver Disease, Tianjin Second People's Hospital, Tianjin Medical Institute of Hepatology, Tianjin 300192, P.R. China, Postgraduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P.R. China, Department of Clinical Laboratory, Tianjin Haihe Hospital, Tianjin 300351, P.R. China
Published online on: September 20, 2021 https://doi.org/10.3892/etm.2021.10760
Article Number: 1325

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Abstract

Tenofovir alafenamide fumarate (TAF) is a first‑line drug for the antiviral treatment of patients with chronic hepatitis B (CHB) in China. In the present study, the efficacy and renal safety of TAF were evaluated in treatment‑naive patients with CHB. Patients with CHB who had not been previously treated with nucleoside analogues (NAs) were recruited before TAF treatment was initiated. Changes in the levels of hepatitis B virus (HBV) DNA, hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) were analyzed at 24 and 48 weeks using immunoassays. In addition, liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were analyzed using transient elastography, while alanine aminotransferase (ALT), triglyceride (TG), total cholesterol (TC) and low‑density lipoprotein‑cholesterol (LDL‑C) levels, calcium (Ca) and inorganic phosphorus (IP) levels were measured using biochemistry assay. In addition, the estimated glomerular filtration rate (eGFR) was calculated. After 48 weeks, the ALT normalization rate was 95.24% (40/42), the complete virological response (HBV DNA <20 IU/ml) rate was 69.05% (29/42) and the HBeAg seroconversion rate was 8.57% (3/35). The levels of HBV DNA and HBsAg were significantly decreased from the baseline at 5.49±1.95 to 1.26±0.66 log₁₀ IU/ml and from 3.59±0.81 to 3.32±0.55 log₁₀ IU/ml after 48 weeks of treatment, respectively. Compared with that in the baseline measurements, LSM at 48 weeks was significantly decreased from 13.00±8.15 to 8.66±4.45 kPa. No significant differences were observed in the TG, TC, LDL‑C, CAP, eGFR, Ca and IP measurements. According to the baseline ALT levels, patients were divided into group A [ALT ≤1 x upper limit of normal (ULN); ULN=50 U/l; n=21], group B (1 x ULN < ALT <2 x ULN; n=22) and group C (ALT ≥2 x ULN; n=18). A significant decrease in HBsAg levels was observed in group B (3.63±0.68 vs. 3.53±0.63 log₁₀ IU/ml) and group C (4.15±0.57 vs. 3.66±0.48 log10 IU/ml) at 24 weeks compared with the baseline. In conclusion, TAF was found to be effective and safe in NA treatment‑naive patients with CHB. Moreover, the higher the ALT levels, the more prominent the curative effect from TAF treatment. Therefore, NA treatment‑naive CHB patients could benefit from TAF treatment in real world.

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