Ma SP, Wang L, Zhang YL, Wan X, Liu Q, Tang YL, Malhi LR, Ge SF. Effects of tenofovir amibufenamide and entecavir on estimated glomerular filtration rate in treatment-naïve patients with chronic hepatitis B. World J Hepatol 2026; 18(2): 114346 [DOI: 10.4254/wjh.v18.i2.114346]
Corresponding Author of This Article
Shan-Fei Ge, Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Zheng Street, Donghu District, Nanchang 330006, Jiangxi Province, China. geshanfei2010@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 27, 2026 (publication date) through Feb 12, 2026
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Journal Information of This Article
Publication Name
World Journal of Hepatology
ISSN
1948-5182
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Ma SP, Wang L, Zhang YL, Wan X, Liu Q, Tang YL, Malhi LR, Ge SF. Effects of tenofovir amibufenamide and entecavir on estimated glomerular filtration rate in treatment-naïve patients with chronic hepatitis B. World J Hepatol 2026; 18(2): 114346 [DOI: 10.4254/wjh.v18.i2.114346]
Shi-Peng Ma, Liang Wang, Yu-Liang Zhang, Xin Wan, Qian Liu, Yu-Lun Tang, Lajpat-Rai Malhi, Shan-Fei Ge, Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Shi-Peng Ma, Department of Nephrology, 3201 Hospital, Hanzhong 723000, Shaanxi Province, China
Co-first authors: Shi-Peng Ma and Liang Wang.
Author contributions: Ma SP contributed to data organization and research design; Ma SP, Wang L, and Zhang YL contributed to manuscript writing; Ma SP, Wang L, Zhang YL, Wan X, Liu Q, and Tang YL contributed to data collection; Malhi LR contributed to manuscript review; Ge SF contributed to research design guidance, writing guidance, and final manuscript revision. Ma SP and Wang L contributed equally to this manuscript and are co-first authors.
Supported by Chinese Foundation for Hepatitis Prevention and Control Muxin Research Fund of Chronic Hepatitis B, No. MX202418.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University [Approval No. (2021) Medical Research Ethics Review (8-016)].
Informed consent statement: As this study was conducted retrospectively, the requirement for written informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All data included in this study are available upon request from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shan-Fei Ge, Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Zheng Street, Donghu District, Nanchang 330006, Jiangxi Province, China. geshanfei2010@163.com
Received: September 19, 2025 Revised: November 1, 2025 Accepted: December 11, 2025 Published online: February 27, 2026 Processing time: 147 Days and 8.5 Hours
Abstract
BACKGROUND
As a novel antiviral agent, the comparative renal safety of tenofovir amibufenamide (TMF) vs entecavir (ETV) in chronic hepatitis B (CHB) remains unclear.
AIM
To compare changes in the estimated glomerular filtration rate (eGFR) between TMF and ETV in previously untreated patients with CHB over 48 weeks.
METHODS
We retrospectively analyzed clinical records of 187 treatment-naive patients with CHB receiving TMF or ETV for ≥ 48 weeks from June 2021 to January 2025. Patients were allocated to the TMF (n = 48) or ETV (n = 139) group based on their antiviral drug therapy. Propensity score matching (2:1) was used to balance baseline clinical characteristics. eGFR changes at 48 weeks were compared. Patients were then stratified into normal and abnormal eGFR groups, and factors associated with abnormal eGFR were analyzed.
RESULTS
After propensity score matching, 48 patients and 96 patients were stratified into the TMF and ETV group, respectively. At baseline, the two groups had comparable clinical characteristics, with no significant differences (P > 0.05). Baseline eGFR values were 111.83 mL/minute/1.73 m2 for the TMF group and 112.50 mL/minute/1.73 m2 for the ETV group (P = 0.712). At week 48, eGFR declined in both groups, but the ETV group experienced a significantly greater reduction relative to the TMF group (106.10 mL/minute/1.73 m2vs 111.01 mL/minute/1.73 m2; P = 0.019). In univariate analysis, the groups differed significantly in terms of age, serum albumin, triglyceride, and baseline eGFR (all P < 0.05). Multivariate analysis identified baseline eGFR and triglyceride as independent predictors of abnormal eGFR by 48 weeks (P < 0.05).
CONCLUSION
In treatment-naïve patients with CHB, ETV treatment exhibited a strong association with an increased risk of decreased eGFR levels at 48 weeks in comparison with TMF.
Core Tip: This study provides the comparison of renal safety between tenofovir amibufenamide (TMF) and entecavir (ETV) in treatment-naive chronic hepatitis B patients. After propensity score matching, TMF showed significantly less decline in estimated glomerular filtration rate over 48 weeks than ETV. Baseline estimated glomerular filtration rate and triglyceride levels independently predicted abnormal renal function, highlighting TMF’s potential renal safety advantage over ETV and offering clinicians important insights for individualized antiviral therapy.
