Author/Authors :
Akdemir Kalkan, Irem Department of Infectious Diseases and Clinical Microbiology - School of Medicine - Ankara University, Ankara, Turkey , Karasahin, Omer Department of Infectious Diseases and Clinical Microbiology - Erzurum Research and Education Hospital, Erzurum, Turkey , Sarigul, Figen Department of Infectious Diseases and Clinical Microbiology - Antalya Research and Education Hospital, Antalya, Turkey , Altunisik Toplu, Sibel Department of Infectious Diseases and Clinical Microbiology - ˙Inönü University School of Medicine, Malatya, Turkey , Aladag, Murat Department of Gastroenterology - ˙Inönü University School of Medicine, Malatya, Turkey , Akgul, Fethiye Department of Infectious Diseases and Clinical Microbiology - Batman Research and Education Hospital, Batman, Turkey , Ozlem Mete, Ay se Department of Infectious Diseases and Clinical Microbiology - Gaziantep University School of Medicine, Gaziantep, Turkey , Golbol, Abdullah Department of Infectious Diseases and Clinical Microbiology - Adana City Hospital, Adana, Turkey , Nazik, Selcuk Department of Infectious Diseases and Clinical Microbiology - School of Medicine - Imam University, Kahramanmara¸s, Turkey , Kömür, Süheyla Department of Infectious Diseases and Clinical Microbiology - Çukurova University School of Medicine, Adana, Turkey , Merve Oren, Meryem Department of Public Health - Istanbul University School of Medicine, Istanbul, Turkey , Yildiz, Yesim Department of Infectious Diseases and Clinical Microbiology - Gazi University School of Medicine, Ankara, Turkey , Demir, Yakup Department of Infectious Diseases and Clinical Microbiology - Dicle University School of Medicine, Kıtılbıl, Turkey , Ayhan, Merve Batman Freelance Pharmacist, Batman, Turkey , Tasova, Yesim Department of Infectious Diseases and Clinical Microbiology - Çukurova University School of Medicine, Adana, Turkey , Bayındır, Yasar Department of Infectious Diseases and Clinical Microbiology - ˙Inönü University School of Medicine, Malatya, Turkey , Dal, Tuba Department of Microbiology - Yıldırım Beyazıt University School of Medicine, Ankara, Turkey , Celen, Mustafa K. Department of Infectious Diseases and Clinical Microbiology - Dicle University School of Medicine, Kıtılbıl, Turkey
Abstract :
Background: In chronic hepatitis B patients with or exposed to the risk of osteoporosis or renal dysfunction, switching from tenofovir
disoproxil fumarate (TDF) to tenofovir alafenamide fumarate (TAF) or entecavir (ETV) may be the right choice.
Objectives: This study aimed to present real-life data in terms of the efficacy and safety of a TAF/ETV treatment change while receiving
TDF.
Methods: This retrospective study was conducted on 344 adult patients from 10 centers. The data of patients who had changed to
ETV (n = 107) and TAF (n = 237) while receiving TDF were analyzed. The data collected at 0 and 6 months of treatment were analyzed.
The virological response was assessed based on undetected hepatitis B virus (HBV) DNA. Serum alanine aminotransferase (ALT) values
were used to evaluate the biochemical response. For renal function, serum creatinine and phosphorus, as well as estimated
glomerular filtration rate (eGFR), were recorded. Moreover, lumbar spine and hip T-scores along with the serum lipid profile were
evaluated.
Results: The mean age of patients was 41.14 13.46 years, and 224 (65.1%) of the participants were male. The treatment arms were
not significantly different in terms of demographic characteristics, comorbid diseases, infection duration, family history of HBV
infection, blood platelet count, serum biomarkers, such as ALT, phosphorus, creatinine, total bilirubin, albumin, lipid profile, and
HBV DNA levels at the beginning. No statistically significant difference was found between the proportion of undetectable HBV DNA
of thetwotreatment groups after6months(P=0.221). The ALT normalization in the ETVandTAF groups at the sixthmonthcompared
to the baseline levels was not significantly different (P = 0.853, P = 0.330, respectively). There wasnostatistically significant difference
between the two treatment arms regarding changes in eGFR, creatinine, phosphorus, hip, and spine T-scores from baseline to 6
months (P = 0.296, P = 0.78, P = 0.141, P = 0.832, P = 0.947, respectively). In those who switched to TAF or ETV, low-density lipoproteins
cholesterol were observed to be significantly higher after 6 months compared to baseline values (P = 0.002, P = 0.049, respectively).
The TC increased significantly in the TAF group (P = 0.035).
Conclusions: Our study showed that switching to ETV and TAF sustained the viral suppression and biochemical response achieved
by TDF therapy. The treatment switch to TAF of ETV can control renal dysfunction and reduce bone mineral density caused by TDF.
