Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis
Recommended Citation
Shahzil M, Chaudhary AJ, Kashif T, Qureshi AA, Muhammad A, Khan F, Faisal MS, Khaqan MA, Ali H, Dababneh Y, and Moonka D. Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis. JGH Open 2024; 8(11):e70055.
Document Type
Article
Publication Date
11-1-2024
Publication Title
JGH Open
Abstract
BACKGROUND: Hepatitis B virus (HBV) infection causes liver disease, including hepatocellular carcinoma. Controlling viral activity is crucial to reducing complications. Tenofovir may offer benefits over entecavir, but it is unclear if switching from entecavir to tenofovir improves outcomes. This study assesses the clinical impact of switching to tenofovir therapy for chronic HBV infection.
METHODS: Following the PRISMA guidelines, we conducted a literature search within the Cochrane Library, PubMed, MEDLINE, Embase, and Scopus for studies of patients with HBV infection who were switched to tenofovir from entecavir or were maintained on entecavir. Both formulations of tenofovir, that is, tenofovir disoproxil fumarate and tenofovir alafenamide were included and analyzed in subgroup analysis. Meta-analyses were performed with RevMan 5.4 using a random-effects model, with statistical significance set at p < 0.05.
RESULTS: A total of eight studies, comprising 833 patients, were included in the meta-analysis. Tenofovir showed a significantly higher likelihood of achieving complete virological response (RR 5.60; 95% CI 3.51-8.94; p < 0.00001) and a greater reduction in HBV DNA levels (MD -1.03 log IU/mL; 95% CI -1.69 to -0.36; p = 0.002) compared to entecavir. However, there was no significant difference in HBsAg reduction or HBeAg seroconversion between the two groups. ALT reductions were not statistically significant overall, although entecavir showed better outcomes in subgroup analysis.
CONCLUSION: Switching from entecavir to tenofovir improves virological response and reduces HBV DNA levels, but shows no significant advantage in HBsAg reduction, HBeAg seroconversion, or overall, ALT reduction.
PubMed ID
39588267
Volume
8
Issue
11
First Page
70055
Last Page
70055
