Published online Nov 28, 2023. doi: 10.3748/wjg.v29.i44.5907
Peer-review started: September 2, 2023
First decision: October 16, 2023
Revised: October 29, 2023
Accepted: November 14, 2023
Article in press: November 14, 2023
Published online: November 28, 2023
Processing time: 86 Days and 2.3 Hours
Hepatitis B virus (HBV) infection may lead to cirrhosis and hepatocellular carcinoma, and the exploration of optimal antiviral drugs can improve patient prognosis.
Tenofovir amibufenamide (TMF) is a new antiviral drug with limited research on its safety and efficacy. Our research may provide new evidence for the treatment of patients with HBV infection.
To compare the efficacy and safety of TMF and tenofovir alafenamide (TAF) for 48 wk in patients with chronic hepatitis B (CHB). The primary outcome was the proportion of virological responses (VR) at 48 wk. Additional outcomes included the changes of renal function and lipid characteristic markers at weeks 24 and 48 compared to baseline.
In this retrospective study, we enrolled a total of 587 patients who had been HBsAg positive for more than 6 mo. Of the enrolled patients, 215 were included in the final analysis and were divided into two groups based on their drug selection: The TMF group and the TAF group.
The VR rates of the TMF group and TAF group were comparable at 24 and 48 wk of treatment (P > 0.05). In patients with low-level viremia, hepatitis B e antigen (HBeAg) positive, and HBeAg negative, their VR rates are also similar. The alanine transaminase (ALT) normalization rate and renal safety of TMF are also comparable to those of TAF. However, total cholesterol levels increased in the TAF group (P = 0.045). In patients with liver cirrhosis, the renal safety, VR, and ALT normalization rate were comparable between the TMF group and the TAF group.
TMF is as effective as TAF in treating CHB and has considerable safety. Moreover, TMF may have more advantages in lipid profile compared to TAF.
The design and research of new nucleotide analogs should continue in the hope of achieving clinical cure of hepatitis B infection as soon as possible.