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Efficacy of entecavir, tenofovir disoproxil fumarate, and tenofovir alafenamide in treatment-naive hepatitis B patients

 Hye Yeon Chon  ;  Sang Hoon Ahn  ;  Yoon Jun Kim  ;  Jung-Hwan Yoon  ;  Jeong-Hoon Lee  ;  Dong Hyun Sinn  ;  Seung Up Kim 
 HEPATOLOGY INTERNATIONAL, Vol.15(6) : 1328-1336, 2021-12 
Journal Title
Issue Date
Aged ; Alanine ; Antiviral Agents / therapeutic use ; Carcinoma, Hepatocellular* / drug therapy ; Carcinoma, Hepatocellular* / epidemiology ; Guanine / analogs & derivatives ; Hepatitis B* / drug therapy ; Hepatitis B, Chronic* / drug therapy ; Humans ; Liver Neoplasms* / drug therapy ; Liver Neoplasms* / epidemiology ; Male ; Tenofovir / analogs & derivatives ; Tenofovir / therapeutic use ; Treatment Outcome
Chronic hepatitis B ; Entecavir ; Hepatocellular carcinoma ; Tenofovir alafenamide ; Tenofovir disoproxil fumarate
Background and aims: Antiviral agents for chronic hepatitis B (CHB) reduced the risk of hepatocellular carcinoma (HCC) development. The outcomes of entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) were compared in patients with CHB.

Methods: Between 2017 and 2019, treatment-naïve patients with CHB treated with ETV, TDF, and TAF were recruited from three Korean tertiary institutes. The cumulative incidences of HCC and orthotopic liver transplantation (OLT) or mortality were calculated and compared using Kaplan-Meier analysis before and after trimatch.

Results: Among recruited 2082 patients, 43 patients developed HCC, whereas 66 developed OLT or mortality. Before trimatch, the cumulative incidence of HCC was statistically similar among patients treated with three antiviral agents (p = 0.340). However, the cumulative probability of OLT or mortality development in patients treated with ETV or TDF was significantly higher than that of patients with TAF before trimatch (all p < 0.05). On multivariate analysis, male sex [hazard ratio (HR) 2.990] and older age (HR 1.044) were independently associated with an increased risk of HCC development, whereas higher platelet count (HR 0.993) was independently associated with a decreased risk (all p < 0.05). The type of antiviral agents did not significantly influence the risk of HCC and OLT or mortality development (all p > 0.05). After trimatch, no significant difference in the cumulative probability for HCC and OLT or mortality according to antiviral agents was found (all p > 0.05).

Conclusions: The outcomes of ETV, TDF, and TAF on the risk of HCC and OLT or mortality were statistically similar in treatment-naïve patients with CHB.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
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