Long-term effects of entecavir and tenofovir treatment on the fibrotic burden in patients with chronic hepatitis B
- Authors
- Chon, Young Eun; Kim, Seung Up; Seo, Yeon Seok; Lee, Hye Won; Lee, Han Ah; Kim, Mi Na; Roh, Yun Ho; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Tak, Won Young; Park, Soo Young; Kim, Beom Kyung
- Issue Date
- Jan-2022
- Publisher
- Blackwell Publishing Inc.
- Keywords
- APRI; Entecavir; FIB-4; Fibrosis; Tenofovir
- Citation
- Journal of Gastroenterology and Hepatology, v.37, no.1, pp 200 - 207
- Pages
- 8
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Gastroenterology and Hepatology
- Volume
- 37
- Number
- 1
- Start Page
- 200
- End Page
- 207
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54328
- DOI
- 10.1111/jgh.15678
- ISSN
- 0815-9319
1440-1746
- Abstract
- Background and Aim
Antiviral therapy (AVT) induces fibrosis regression in patients with chronic hepatitis B. We investigated long-term effects of entecavir (ETV) versus tenofovir (TDF) on fibrotic burden.
Methods
Treatment-naïve chronic hepatitis B patients who had begun ETV or TDF were recruited from four tertiary hospitals. The aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) were used to determine fibrotic burden.
Results
In the entire population (n = 3277), although patients treated with ETV had higher baseline APRI (1.71 vs 1.07, P < 0.001) and FIB-4 (3.60 vs 2.80, P < 0.001) than those treated with TDF, significant fibrosis regression was identified during 6 years of AVT in both ETV (APRI, mean 1.71 → 0.48, P < 0.001; FIB-4, mean 3.60 → 2.21, P < 0.001) and TDF groups (APRI, mean 1.07 → 0.43, P < 0.001; FIB-4, mean 2.80 → 2.19, P < 0.001). In patients without cirrhosis (n = 2366), baseline APRI was significantly higher in ETV group than in TDF group (1.72 vs 0.97, P < 0.001); however, they became similar after 6 months. Similarly, baseline FIB-4 was significantly higher in ETV group than in TDF group (3.25 vs 2.35, P < 0.001), but became similar from 4 to 6 years. In patients with cirrhosis (n = 911), baseline APRI (1.70 vs 1.34, P < 0.001) and FIB-4 (4.62 vs 3.91, P = 0.005) were higher in ETV group than in TDF, however, both parameters became statistically similar from 6 months to 6 years.
Conclusion
Significant regression of APRI and FIB-4 was observed during long-term ETV and TDF treatment. Despite higher baseline fibrotic burden in ETV group, fibrotic burden between the groups eventually converged through significant fibrosis regression after 1 to 4 years of AVT.
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Collections - 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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