Comparison of biochemical response during antiviral treatment in patients with chronic hepatitis B infection

Si Ho Kim, Eun Ju Cho, Boo ok Jang, Kyunghan Lee, Jae Kyun Choi, Gwang Hyeon Choi, Jeong Hoon Lee, Su Jong Yu, Yoon Jun Kim, Yun Bin Lee, Jeong Hwan Yoon, Jin Wook Kim, Sook Hyang Jeong, Eun Sun Jang

Research output: Contribution to journalArticlepeer-review

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Background & Aims: This multicenter cohort study aimed to compare the real-world biochemical response rates during tenofovir alafenamide (TAF), tenofovir disoproxil fumarate (TDF), and entecavir (ETV) treatment in chronic hepatitis B virus (HBV) infection patients. Methods: Overall, 1282 treatment-naïve patients with CHB who commenced TAF (n = 270), TDF (n = 617), or ETV (n = 395) were analysed for biochemical response rates during the antiviral treatment using a time-dependent Cox proportional hazard model after the inverse probability of treatment weighting (IPTW). Results: Patients treated with ETV were older (55.1 ± 11.5 years) than TAF or TDF (P <.0001). ETV was more frequently prescribed to patients with diabetes mellitus (DM, P =.003), hypertension (P <.0001), chronic kidney disease (P <.0001), and negative e-antigen (P <.0001). Cumulative biochemical response rate was independently lower in patients with radiologic fatty liver (HR, 0.75; 95% CI, 0.61-0.94) and obese patients without DM (HR, 0.85; 95% CI, 0.68-0.98) according to multivariable Cox analyses based on time-dependent variables after IPTW for age, sex, liver cirrhosis, baseline e-antigen, ALT, and HBV DNA levels. ETV treated patients (HR, 1.38; 95% CI, 1.13-1.68) showed higher biochemical response rates compared with TAF- or TDF-treated patients after adjusting for similar parameters. Conclusions: In real-world practice, ETV was preferable for older, hepatitis B e-antigen negative patients with underlying comorbidities. Biochemical responses in patients treated with ETV, TAF, and TDF were significantly affected by metabolic factors such as fatty liver, obesity, and DM. However, the mechanism behind the higher biochemical response rate in patients treated with ETV should be investigated further.

Original languageEnglish
Pages (from-to)320-329
Number of pages10
JournalLiver International
Issue number2
StatePublished - Feb 2022


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