Real‐life impact of tenofovir disoproxil fumarate and entecavir therapy on lipid profile, glucose, and uric acid in chronic hepatitis B patients

Abstract

The impact of long-term nucleos(t)ide analogs treatment on host metabolism is a concern. Hence, we conducted this study to compare the effect of entecavir (ETV) and tenofovir disoproxil fumarate (TDF) on metabolic parameters among chronic hepatitis B (CHB) patients. In this real-life retrospective study, 2030 CHB outpatients treated with ETV or TDF at Nanfang Hospital, China, were included.For treatment-naïve patients, pretreatment and semiannual metabolic parameters were collected. For treatment-experienced patients, metabolic parameters were collected at the first visit. Propensity score matching (PSM) was used to balance the effects of potential confounding factors. Among 122 treatment-naïve patients and 1908 treatment-experienced patients, ETV-treated patients were older with a higher percentage of metabolic syndrome. After PSM, the characteristics were comparable between the two groups. For treatment-naïve patients, four lipid parameters, including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein, and triglyceride levels showed a decreasing trend during the 42-month TDF treatment, while they remained relatively stable or increased during ETV treatment. At Month 30, the levels of TC and LDL among TDF-treated patients were significantly lower than those among ETV-treated patients (TC: 4.7 mmol/L vs.

Comparative Impact of TDF and ETV on the Prognosis of HCC Patients with Concurrent MASLD and HBV Infection after Hepatectomy

“…A recent study suggested that ETV might elevate the risk of lipid parameter rise, incorporating lowdensity lipoprotein, total cholesterol and triglyceride levels. 34 Abnormal lipid metabolism can increase the risk of adverse outcomes for HCC patients with hepatic steatosis. 35 Our subgroup analysis concluded that with normal levels of LDL and TG, TDF enhancement of OS in patients was more noticeable, suggesting further that abnormal lipid levels instigated by ETV could potentially elevate the risk of unfavorable prognosis in HPMH.…”

“…Some studies also reported that compared with ETV, TDF tends to have a lipid-lowering effect, featuring a more substantial decline in total cholesterol, LDL, and HDL in chronic hepatitis B patients. 34,36 We collected TG and LDL levels in the two groups before and 6 months after surgery and analyzed the data using the Wilcoxon signed-rank test, with a P value < 0.05 37 (Figure S4). Furthermore, during patient follow-up, 23 (19.5%) individuals in the ETV group were newly discovered to have carotid artery plaques, while in the TDF group, 5 (4.7%) individuals were newly found to have carotid artery plaques.…”