Long-Term Effectiveness of Tenofovir Alafenamide Versus Entecavir in Treatment-Naive Chronic Hepatitis B: A Real-World Evidence from the Global Alliance for the Study of Hepatitis B Virus

作者：Jie Li, Joanne Kimiko Liu, Angela Chau, S. Van Der Linden, Pei‐Chien Tsai, Akito Nozaki, Philip Vutien, Haruki Uojima, Hidenori Toyoda, Takashi Honda, Huy N. Trinh, Hiroshi Abe, Toru Ishikawa, Masanori Atsukawa, Tsunamasa Watanabe, Kunihiko Tsuji, Daniel Q. Huang, Koichi Takaguchi, Ei Itobayashi, Sebastián Marciano, Fajuan Rui, Wenjing Ni, Kazuhiro Takahashi, Wan‐Long Chuang, Chia‐Yen Dai, Jee‐Fu Huang, Chung‐Feng Huang, Ming‐Lun Yeh, Yixuan Zhu, Norio Itokawa, Ritsuzo Kozuka, Kaori Inoue, Tomonori Senoh, Mayumi Maeda, Takanori Ito, Manabu Morimoto, Ramsey Cheung, Adrián Gadano, Masaru Enomoto, Yasuhito Tanaka, Seng Gee Lim, Chao Wu, Ming‐Lung Yu, Mindie H. Nguyen · 发表于：The American Journal of Gastroenterology · 年份：2025 · DOI：10.14309/ajg.0000000000003881 · 被引用次数：2 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、HIV/AIDS drug development and treatment

INTRODUCTION: Although both tenofovir alafenamide (TAF) and entecavir (ETV) are recommended first-line treatments for chronic hepatitis B, comparative data on their effectiveness remain limited. We aim to compare their virologic (VR), biochemical (BR), and complete (CR) response rates. METHODS: This retrospective study enrolled treatment-naive chronic hepatitis B patients who initiated either TAF or ETV in 2016 or after across 22 international centers and evaluated their treatment response after balancing their characteristics using inverse probability treatment weighting and through Fine-Gray competing-risks analysis of the balanced cohort. RESULTS: The study included 1,605 patients (784 TAF and 821 ETV patients with significant background differences) of whom 1,553 (96.8%) were from Asia. Inverse probability treatment-weighting analysis yielded a total weighted cohort of 1,660 (822 TAF and 838 ETV patients with balanced characteristics). The 5-year cumulative VRs were high in both groups with a slightly higher rate in TAF patients (98.0% vs 93.9%, P < 0.001), and similar findings were found in a subgroup analysis by median hepatitis B virus (HBV) DNA (5.5 log IU/mL). However, there was no significant difference in the 5-year BR rates overall (93.7 vs 92.8%, P = 0.484) or by alanine aminotransferase (ALT) cutoff of 2× upper limit of normal. TAF patients had a slightly higher 5-year cumulative CR overall (94.9% vs 89.4%, P = 0.001) and in high HBV DNA (96.9% vs 87.9%, P < 0.0...