Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
Aliment Pharmacol Ther. 2024 Jan;59(2):230-238. doi: 10.1111/apt.17765. Epub 2023 Oct 16.
Lipid-lowering effect was observed during treatment with tenofovir disoproxil fumarate (TDF) for chronic hepatitis B (CHB). However, the metabolic features in patients switching from TDF to tenofovir alafenamide (TAF) remain unclear.
To compare the impacts of switching from TDF to TAF or from entecavir to TAF on body weight and metabolic features in patients with CHB.
This was a multi-centre, prospective, observational study in patients with CHB on TDF or entecavir who switched to TAF. Baseline characteristics, lipid profile and sugar profile were determined. This study received IRB approval from each hospital.
We enrolled 177 patients on TDF (99) or entecavir (78) and followed them for 48 weeks after the switch to TAF. At baseline, TDF-experienced patients had lower serum triglyceride, total cholesterol, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol than entecavir-experienced patients. The switch from TDF to TAF significantly increased body weight, triglyceride, total cholesterol, HDL, LDL, fasting glucose, glycaemic haemoglobin, insulin and insulin resistance. The switch from entecavir to TAF did not affect these measures. There was no significant difference in atherosclerotic cardiovascular disease risk scores between groups.
The switch from TDF to TAF was associated with weight gain, derangements of lipid profile, and increased insulin resistance in patients with CHB. Long-term effects on these metabolic features need further investigation.
替诺福韦二吡呋酯（TDF）治疗慢性乙型肝炎（CHB）时可观察到降脂作用。然而，从 TDF 转换为替诺福韦艾拉酚胺（TAF）的患者的代谢特征尚不清楚。
比较从 TDF 转换为 TAF 或从恩替卡韦转换为 TAF 对 CHB 患者体重和代谢特征的影响。
这是一项多中心、前瞻性、观察性研究，纳入了正在接受 TDF 或恩替卡韦治疗的 CHB 患者，这些患者转换为 TAF。确定了基线特征、血脂谱和糖谱。本研究获得了每家医院的 IRB 批准。
我们纳入了 177 例 TDF（99 例）或恩替卡韦（78 例）经验的患者，并在转换为 TAF 后随访了 48 周。在基线时，TDF 经验的患者血清甘油三酯、总胆固醇、高密度脂蛋白（HDL）胆固醇和低密度脂蛋白（LDL）胆固醇均低于恩替卡韦经验的患者。从 TDF 转换为 TAF 显著增加了体重、甘油三酯、总胆固醇、HDL、LDL、空腹血糖、糖化血红蛋白、胰岛素和胰岛素抵抗。从恩替卡韦转换为 TAF 则不会影响这些指标。各组间的动脉粥样硬化性心血管疾病风险评分无显著差异。
从 TDF 转换为 TAF 与 CHB 患者的体重增加、血脂谱紊乱和胰岛素抵抗增加有关。需要进一步研究这些代谢特征的长期影响。
