Comparative antiviral efficacy with higher ALT normalization of tenofovir alafenamide (TAF) versus tenofovir disoproxil fumarate (TDF) in HBeAg-negative, genotype D chronic hepatitis B

Ricco, G.; Buti, María; Omata, Masao; Kim, Y.J.; Coco, B.; Samuel, Didier; Flaherty, John F.; Lin, Lanjia; Gaggar, Anuj; Ceauşu, Emanoil; Akarca, Ulus Salih; Tong, Myron J.; Chan, Henry Lik‐Yuen; Brunetto, M.R.

doi:10.1016/j.dld.2017.01.126

Cited by 1 publication

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“…[38] is an ongoing study. 18 studies [26,31,[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] were included in meta-analysis (Figure 2). Characteristics of included and excluded studies are described in annexed tables (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Thus, scale-up of HIV therapy could lead to fewer patients developing CKDs and HIV related co-morbidities. By the way this is likely to be one of the most effective public health strategies to reduce TDF drug toxicity; similarly, best way of enhancing HIV/Hepatitis B coinfection, reducing the risk of hepatitis B complications [56][57][58][59][60][61][62][63][64][65][66][67][68][69][70].…”

Section: Discussionmentioning

confidence: 99%

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Tenofovir Alafenamide versus Tenofovir Disoproxil Fumarate: Systematic Review and Meta-Analysis

Tamuzi¹

2018

IJOPRS

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Background: Highly active antiretroviral therapy (HAART) has greatly reduced morbidity and mortality. Despite the impact of antiretroviral therapy (ART), mortality in successfully treated HIV infected patients remains higher than in the general uninfected population, more specifically in Sub-Saharan Africa. In fact, ART has demonstrated toxicity. tenofovir disoproxil (TDF) is widely known, even so, TDF is known as nephrotoxic. Recently, tenofovir alafenamide (TAF) was found. TAF is a new oral prodrug of tenofovir, less toxic than TDF. TAF has potential intracellular accumulation; lower extracellular exposures of tenofovir may be realized with the potential to reduce off-target toxicities. Additionally, TAF has shown its efficacy in HIV-Hepatitis B co-infection.Objectives: To investigate whether TAF based regimens are less renal and borne toxic than TDF based regimens. To evaluate the efficacy of TAF versus TDF in HIV/hepatitis B co-infection. Methods:We searched in studies in following databases: CENTRAL (Cochrane Central Register of Controlled Trials), Scopus, Web of science, LILACS, PubMed and CINAHL. We also searched conference abstract through HIV/AIDS website.Main results: Among 916 studies found in different databases, 764 were screened after removing duplicate studies, 36 studies were included in qualitative studies. Among them, 16 studies were excluded with specific reasons. 18 RCTs were included in meta-analysis. Of the 12 RTCs assessing the OR of HIV-RNA<50RNAc/ml from 48 to 96 weeks, HIV-infected patients on TAF based regimens reduced HIV-RNA<50RNAc/ ml by 13% compared to TDF contained group (P=0.02). For 10 RCTs included in clearance creatinine rate comparing TAF to TFD based regimens, the glomerular filtration rate yielded a pooled MD estimate of -3.94(-6.07 to-1.81, P<0.000001). The OR of HBV-DNA after 48 weeks between TAF and TDF was reduced by 29% (4 RCTs were included) with P=0.02. TDF individuals had a low MD of CD4 count (cells/µl) than TAF group (MD -18.99, 6 studies, P<00001). The MD of percentage change hip bone mineral density was decreased in TFD compared to TAF -1.93 with P<0.00001 and 11 RCTs were included as well as the MD of percentage change spine bone mineral density was decreased in TFD compared to TAF -1.77 (-1.97 to -1.58) with P=0.001. The odds of ALT above ULN was reduced by 25% in TAF group compared to TDF group (P=0.04). Any adverse events and serious adverse events were not significant in both TAF and TDF groups. We graded the evidence as high in all outcomes except in bone Mineral Density and proteinuria where the evidence was respectively low and moderate. Conclusion:Evidence suggests that use of TAF is more protective and effective than either TDF. Improving renal and hepatic related comorbidities in HIV-infected population, TAF may be beneficial in public health policy, specifically in high HIV epidemic regions.

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