Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐Analysis
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....
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| Format: | Article |
| Language: | English |
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Wiley
2024-11-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.70055 |
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| author | Muhammad Shahzil Ammad Javaid Chaudhary Talha Kashif Ali Akram Qureshi Anza Muhammad Faiza Khan Muhammad Saad Faisal Muhammad Ali Khaqan Hassam Ali Yara Dababneh Dilip Moonka |
| author_facet | Muhammad Shahzil Ammad Javaid Chaudhary Talha Kashif Ali Akram Qureshi Anza Muhammad Faiza Khan Muhammad Saad Faisal Muhammad Ali Khaqan Hassam Ali Yara Dababneh Dilip Moonka |
| author_sort | Muhammad Shahzil |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-d3e88f4f4b144ac9aa3487a11f7320be |
| institution | Kabale University |
| issn | 2397-9070 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj-art-d3e88f4f4b144ac9aa3487a11f7320be2024-11-28T07:56:34ZengWileyJGH Open2397-90702024-11-01811n/an/a10.1002/jgh3.70055Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐AnalysisMuhammad Shahzil0Ammad Javaid Chaudhary1Talha Kashif2Ali Akram Qureshi3Anza Muhammad4Faiza Khan5Muhammad Saad Faisal6Muhammad Ali Khaqan7Hassam Ali8Yara Dababneh9Dilip Moonka10Department of Internal Medicine Milton S. Hershey Medical Center, The Pennsylvania State University Hershey Pennsylvania USADepartment of Internal Medicine Henry Ford Hospital Detroit Michigan USADepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Internal Medicine Henry Ford Hospital Detroit Michigan USADepartment of Internal Medicine John H. Stroger, Jr. Hospital of Cook County Chicago Illinois USADepartment of Gastroenterology ECU Health Greenville North Carolina USADepartment of Gastroenterology and Hepatology Henry Ford Hospital Detroit Michigan USADepartment of Gastroenterology and Hepatology Henry Ford Hospital Detroit Michigan USAABSTRACT 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.https://doi.org/10.1002/jgh3.70055antiviral agentschronicdrug substitutionentecavirhepatitis Btenofovir |
| spellingShingle | Muhammad Shahzil Ammad Javaid Chaudhary Talha Kashif Ali Akram Qureshi Anza Muhammad Faiza Khan Muhammad Saad Faisal Muhammad Ali Khaqan Hassam Ali Yara Dababneh Dilip Moonka Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐Analysis JGH Open antiviral agents chronic drug substitution entecavir hepatitis B tenofovir |
| title | Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐Analysis |
| title_full | Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐Analysis |
| title_fullStr | Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐Analysis |
| title_full_unstemmed | Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐Analysis |
| title_short | Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta‐Analysis |
| title_sort | switching to tenofovir therapy versus continuation of entecavir for patients with hepatitis b virus infection a systematic review and meta analysis |
| topic | antiviral agents chronic drug substitution entecavir hepatitis B tenofovir |
| url | https://doi.org/10.1002/jgh3.70055 |
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