Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 27, 2023; 15(8): 964-972
Published online Aug 27, 2023. doi: 10.4254/wjh.v15.i8.964
Tenofovir alafenamide significantly increased serum lipid levels compared with entecavir therapy in chronic hepatitis B virus patients
Rui-Min Lai, Shan Lin, Miao-Miao Wang, Na Li, Jia-Hui Zhou, Xiao-Yu Lin, Tian-Bin Chen, Yue-Yong Zhu, Qi Zheng
Rui-Min Lai, Shan Lin, Na Li, Jia-Hui Zhou, Xiao-Yu Lin, Yue-Yong Zhu, Qi Zheng, Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou 350005, Fujian Province, China
Rui-Min Lai, Qi Zheng, Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, China
Miao-Miao Wang, Department of Endocrinology, The 910th Hospital of The Joint Service Support Force, Quanzhou 362000, Fujian Province, China
Tian-Bin Chen, Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
Author contributions: Lai RM and Lin S contributed equally to this work; Lai RM and Lin S conceived and designed the study; Chen TB and Zhou JH contributed to the data analysis and manuscript feedback; Li N and Wang MM collected clinical data of the patients; Lai RM and Zheng Q wrote the manuscript; All authors approved the final version of the manuscript.
Supported by Natural Science Foundation of Fujian Province, No. 2021J01123300.
Institutional review board statement: This retrospective study was approved by the ethics committee at the First Affiliated Hospital of Fujian Medical University, China.
Informed consent statement: Patients were not required to give informed consent to the study as the analysis used anonymous data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at bei0825@163.com.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi Zheng, PhD, Chief Physician, Professor, Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, No. 20 Chazhong Road, Taijiang District, Fuzhou 350005, Fujian Province, China. bei0825@163.com
Received: March 20, 2023
Peer-review started: March 20, 2023
First decision: May 18, 2023
Revised: May 26, 2023
Accepted: August 3, 2023
Article in press: August 3, 2023
Published online: August 27, 2023
Processing time: 154 Days and 16.1 Hours
Abstract
BACKGROUND

Tenofovir alafenamide (TAF) has a serum lipid-raising effect in patients with HIV; however, its effect on serum lipids and nonalcoholic fatty liver disease (NAFLD) risk in patients with chronic hepatitis B (CHB) is unclear.

AIM

To compare the effects of TAF and entecavir (ETV) on serum lipid levels in patients with CHB.

METHODS

In this retrospective cohort study, the data including the clinical features, serum lipids, and metabolic factors of patients with CHB at baseline and approximately 1 year after TAF or ETV treatment were collected and analyzed. We used propensity score-matched models to assess the effects on high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol (TCHO).

RESULTS

A total of 336 patients (75.60% male) were included; 63.69% received TAF and 36.31% received ETV. Compared with the ETV group, the TAF group had significantly higher TCHO levels after treatment (4.67 ± 0.90 vs 4.36 ± 1.05, P = 0.006). In a propensity score-matched model for body mass index, age, sex, smoking, drinking, presence of comorbidities such as NAFLD, cirrhosis, diabetes mellitus, and hypertension, TAF-treated patients had significantly increased TCHO levels compared to that at baseline (P = 0.019). There was no difference for the ETV group. Body mass index, sex, hypertension, baseline TCHO, and creatine kinase-MB isoenzyme levels were significantly associated with elevated TCHO levels in logistic regression analysis. However, 1-year TAF treatment did not increase the incidence of NAFLD.

CONCLUSION

A greater increase in TCHO was observed in patients with CHB receiving TAF compared to those receiving ETV. However, TAF-induced dyslipidemia did not increase the incidence of NAFLD.

Keywords: Tenofovir alafenamide; Entecavir; Hepatitis B virus; Serum lipid; Metabolic factor

Core Tip: This study compared the effects of tenofovir alafenamide (TAF) and entecavir on serum lipid levels in chronic hepatitis B patients. The results suggested that TAF-treated patients had significantly increased triglycerides, and total cholesterol levels compared to that at baseline, while there was no difference in the entecavir group. However, dyslipidemia caused by TAF therapy did not increase the incidence of nonalcoholic fatty liver disease. Our findings indicated that the potential impact of anti-viral therapy on the lipid profile may be an important consideration in the treatment choices for chronic hepatitis B patients with abnormal metabolic factors.