A National Multicenter Study on Initial Antiviral Treatment Preferences on Chronic Hepatitis B: Entecavir Versus Tenofovir Disoproxil Fumarate

Abstract

Background/Aims: Selecting the initial antiviral regimen for chronic hepatitis B (CHB) requires balancing patients’ comorbidities and long-term safety. This study examines differences in patient and disease-related factors that guide clinicians to prescribe either ente cavir (ETV) or tenofovir disoproxil fumarate (TDF) as the initial treatment.

Materials and Methods: The study included treatment-naïve CHB patients aged 18 or older who had been diagnosed for at least 1 year since 2010 and initiated on antiviral therapy. The data included variables such as age, gender, body mass index (BMI), comorbidities, liver disease activity, biopsy results, cirrhosis, hepatic steatosis, hepatitis B e-antigen status, hepatitis B virus DNA levels, triglycerides, cholesterol, renal function, and baseline bone mineral density (BMD), which were assessed by dual-energy x-ray absorptiometry (DEXA).

Results: Among 2259 patients (61.6% male), 1270 patients (56.22%) received TDF, while 989 patients (43.78%) received ETV as first
line therapy. The TDF was more commonly prescribed to patients with a lower BMI (median