Comparison of tenofovir and entecavir in patients with chronic HBV infection

摘要

BACKGROUND: Sustained suppression of serum HBV DNA levels with nucleos(t)ide analogues is the most important success obtained in the treatment of chronic HBV infection today. Tenofovir and entecavir provide more robust viral suppression. AIM: The aim of this study is to compare tenofovir and entecavir in terms of viral kinetics, side effects and virological response in patients with chronic HBV infection. PATIENTS AND METHODS: Patients with chronic hepatitis B treated with tenofovir or entecavir were included in this retrospective study. Using survey analysis, we evaluated independent variables reflecting virological response to treatment and determined whether use of tenofovir or entecavir was one of them. We compared the decline in serum HBV DNA levels at the 3rd, 6th, 12th, 18th and 24th months of treatment between two groups. We also compared entecavir and tenofovir in terms of side effect rates. RESULTS: 117 patients [average age: 44 (20-73), 65 males (55.6%), 30 HBeAg positive (25.6%)] were enrolled in the study. Sixty-six patients (56.4%) used tenofovir and 51 (43.6%) patients used entecavir. Virological response was better in patients using tenofovir (Odd’s ratio of 1.796 and p = 0.014) and having high fibrosis score (Odd’s ratio of 0.182 and p = 0.018). Entecavir was more effective in reducing serum HBV DNA levels at the 3rd month of treatment (serum HBV DNA decline of 4.45 and 3.96 log10 units for entecavir and tenofovir respectively, p = 0.031), but decline rates were similar at other months. There was no difference between patient groups in terms of side effects and discontinuation of treatment due to side effects. CONCLUSIONS: Patients with chronic HBV infection using tenofovir have better virological response than those using entecavir.