A National Multicenter Study on Initial Antiviral Treatment Preferences on Chronic Hepatitis B: Entecavir Versus Tenofovir Disoproxil Fumarate
Makaleler > Tam Makale · 2025
Yazarlar: Tansu YAMAZHAN, Esra Zerdali, Yusuf Önlen, Selma Tosun, Özgür Günal, Ayşe Batırel, İmran Hasanoğlu, Tuba Turunç, Umay Balcı, Sibel Yıldız Kaya, Oğuz Karabay, İlknur Esen Yıldız, Lütfiye Nilsun Altunal, Hacer Deniz Özkaya, Selçuk Kaya, Ayşe İnci, Sevil Alkan, Dilek Sevgi Yıldız, Tayibe Bal, Esma Aslıhan Aydemir, Nurullah Eser, Serhat Uysal, Oğuzhan Acet, Fehmi Tabak, Rahmet Güner
Turkish Journal of Gastroenterology, Uluslararası, Wos, 2025, cilt 37, ss 179-185
Özet
BACKGROUND/AIMS: Selecting the initial antiviral regimen for chronic hepatitis B (CHB) requires balancing patients' comorbidities and long-term safety. This study examines the differences in patient and disease-related factors that guide clinicians to prescribe either entecavir (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 25.7 vs. 26.2, P = .001) and lower baseline creatinine (0.75 vs. 0.80 for ETV, P < .001). Clinicians preferred ETV among patients with an estimated glomerular filtration rate (eGFR) < 60 (n = 36), (P < .001). The BMD was evaluated in 365 patients (16.3%). The DEXA scans were performed for 116 patients (11.8%) in the ETV group and 249 patients (19.8%) in the TDF group (P < .001). CONCLUSIONS: This national multicenter study emphasizes that patient-related factors, including gender, age, baseline renal function, and liver disease severity, significantly influence the choice of first-line antiviral therapy for CHB, often outweighing disease-specific factors. Cite this article as: Yamazhan T, Zerdali E, Önlen Y, et al. A national multicenter study on initial antiviral treatment preferences on chronic hepatitis B: Entecavir versus tenofovir disoproxil fumarate. Turk J Gastroenterol. 2026;37(2):179-185.