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Abstract Details
Review article: switching patients with chronic hepatitis B to tenofovir alafenamide-a review of current data
Aliment Pharmacol Ther. 2022 Apr;55(8):921-943. doi: 10.1111/apt.16788.Epub 2022 Feb 17.
1University of Ulsan College of Medicine, Seoul, South Korea.
2The University of Hong Kong, Hong Kong.
3The University of Hong Kong-Shenzhen Hospital, Shenzen, China.
4Musashino Red Cross Hospital, Musashino, Japan.
5University of Toronto, Toronto, Canada.
6National Taiwan University Hospital, Taipei, Taiwan.
7Nanfang Hospital, Southern Medical University, Guangzhou, China.
8Henry Ford Health System and Wayne State University School of Medicine, Detroit, MI, USA.
9Gilead Sciences, Foster City, CA, USA.
10King's College Hospital, London, UK.
11Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
12University of Milan, Milan, Italy.
Abstract
Background: The nucleos(t)ide analogues (NAs) entecavir (ETV), tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) are preferred treatment options for patients with chronic hepatitis B infection (CHB). However, resistance to ETV has been reported, especially with prior exposure to other NAs, and long-term TDF treatment has been associated with decline in renal function and loss of bone mineral density in some patients. Consequently, TAF may be preferable to ETV, TDF or other NAs in specific circumstances such as in patients with risk of bone or renal complications, elderly patients or those with previous NA experience.
Aim: To provide a summary of the available efficacy and safety data following switch to TAF from other NAs in patients with CHB in clinical studies and real-world settings.
Methods: Literature searches were performed on PubMed and abstracts from three major international liver congresses between 2019 and 2021. Studies that included efficacy and/or safety data for patients with CHB switching from any NA to TAF were selected.
Results: Thirty-six papers and abstracts were included in this narrative review. Switching from TDF to TAF maintained or improved virological and biochemical responses with improved bone and renal safety. Switching from ETV or other NAs to TAF maintained or improved virological and biochemical responses and varying results for bone and renal safety.
Conclusions: Switching to TAF appears to maintain or improve virological, biochemical and bone- and renal-related safety outcomes. These data support the concept of switching to TAF in some patients with CHB based on their individual circumstances.