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Comparison of Tenofovir Alafenamide and Tenofovir Disoproxil Fumarate for Chronic Hepatitis B Treatment

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In the realm of chronic hepatitis B (CHB) treatment, the comparative effectiveness of tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) has been a subject of interest. This study provides a retrospective analysis of 241 CHB patients treated at a hospital from January 2020 to December 2021. The patients were divided into two groups: 180 received TAF and 61 received TDF. Key metrics such as liver function, serum virus markers, clinical efficacy, adverse reactions, and cost-effectiveness were evaluated to determine the overall effectiveness of each treatment.

Clinical Outcomes

Initial analyses showed no significant difference in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) levels between the two groups before treatment. Post-treatment results indicated that both groups experienced significant reductions in ALT, AST, and TBIL levels, although the difference between the groups was not statistically significant. Furthermore, both groups showed similar conversion rates for Hepatitis B surface antigen (HBsAg) and Hepatitis B virus DNA (HBV-DNA).

Additionally, the study found no statistical significance in the total clinical cure rates between the TAF and TDF groups. However, the TAF group exhibited a lower rate of adverse reactions compared to the TDF group, underscoring TAF’s higher safety profile.

Cost-Effectiveness Analysis

Despite the higher median drug cost for the TAF group, the cost-effectiveness ratio (CER) analysis revealed that the CER of TAF was comparable to that of TDF. This indicates that, while TAF is more expensive, its overall efficacy and safety metrics justify the cost.

Key Takeaways

From the study, several critical inferences can be drawn:

  • TAF and TDF both significantly improve liver function in CHB patients.
  • TAF offers a better safety profile with fewer adverse reactions compared to TDF.
  • Despite its higher cost, TAF’s cost-effectiveness is similar to that of TDF, making it a viable treatment option.

In conclusion, both TAF and TDF therapies are effective in treating CHB, achieving the goal of improved liver function and recovery. The choice between the two may depend on safety considerations and cost-effectiveness analysis, with TAF presenting a higher safety profile.

Original Article: Medicine (Baltimore). 2024 May 17;103(20):e37953. doi: 10.1097/MD.0000000000037953.

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