The efficacy and safety comparison between tenofovir and entecavir in treatment of chronic hepatitis B and HBV related cirrhosis: A systematic review and Meta-analysis

Int Immunopharmacol. 2017 Jan:42:168-175. doi: 10.1016/j.intimp.2016.11.022. Epub 2016 Dec 1.

Abstract

Background: The purpose of this study was to assess the efficacy and safety between tenofovir and entecavir in the treatment of CHB and HBV related cirrhosis through Meta-analysis. Methods The electronic databases of PubMed, the Cochrane Library, Nature, CNKI and WanFang data were searched. The key words were: ("tenofovir", "entecavir") and ("Chronic Hepatitis B" or "CHB") and "Liver cirrhosis". Heterogeneity and report bias were analyzed.

Results: There was significant difference of ALT norm level in the short-term period of 3months (RR=1.43, 95%CI: 1.06-1.94, P<0.017) and 6months (RR=0.89, 95%CI: 0.81-0.97, P<0.017), and significant difference of undetectable HBV-DNA only in 3months follow-up period (RR=1.59, 95%CI: 1.04-2.42, P<0.017) between TDF and ETV, but no significant difference in the long-term period. There is significant difference between TDF and ETV in eGFR level (RR=1.601, 95%CI: 1.035-2.478, P=0.0034) and hypophosphatemia incidence (RR=4.008, 95%CI: 1.485-10.820, P=0.006).

Conclusion: TDF has a better efficacy than ETV in 3months treatment duration, but intriguingly, TDF might not better than ETV during the 6months treatment period in the viral suppression and liver function improvement. There's no significant difference between TDF and ETV in the long-term treatment duration and in the treatment of HBV related liver cirrhosis. Both TDF and ETV could influence renal function but patients under TDF therapy may have more risk to suffer from renal damage and hypophosphatemia.

Keywords: CHB; Chronic hepatitis B; Efficacy; Entecavir; HBV; Safety; Tenofovir.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / prevention & control
  • Guanine / adverse effects
  • Guanine / analogs & derivatives*
  • Guanine / therapeutic use
  • Hepatitis B virus / physiology*
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Hypophosphatemia / etiology
  • Hypophosphatemia / prevention & control
  • Liver Cirrhosis
  • Tenofovir / adverse effects
  • Tenofovir / therapeutic use*
  • Treatment Outcome
  • Viral Load / drug effects*

Substances

  • entecavir
  • Guanine
  • Tenofovir