Work

Effects of tenofovir amibufenamide and entecavir on estimated glomerular filtration rate in treatment-naïve patients with chronic hepatitis B

Year: 2026

Type: article

Abstract: BACKGROUND As a novel antiviral agent, the comparative renal safety of tenofovir amibufenamide (TMF) vs entecavir (ETV) in chronic hepatitis B (CHB) remains unclear. AIM To compare changes in the estimated glomerular filtration rate (eGFR) between TMF and ETV in previously untreated patients with CHB over 48 weeks. METHODS We retrospectively analyzed clinical records of 187 treatment-naive patients with CHB receiving TMF or ETV for ≥ 48 weeks from June 2021 to January 2025. Patients were allocated to the TMF (n = 48) or ETV (n = 139) group based on their antiviral drug therapy. Propensity score matching (2:1) was used to balance baseline clinical characteristics. eGFR changes at 48 weeks were compared. Patients were then stratified into normal and abnormal eGFR groups, and factors associated with abnormal eGFR were analyzed. RESULTS After propensity score matching, 48 patients and 96 patients were stratified into the TMF and ETV group, respectively. At baseline, the two groups had comparable clinical characteristics, with no significant differences (P > 0.05). Baseline eGFR values were 111.83 mL/minute/1.73 m2 for the TMF group and 112.50 mL/minute/1.73 m2 for the ETV group (P = 0.712). At week 48, eGFR declined in both groups, but the ETV group experienced a significantly greater reduction relative to the TMF group (106.10 mL/minute/1.73 m2 vs 111.01 mL/minute/1.73 m2; P = 0.019). In univariate analysis, the groups differed significantly in terms of age, serum albumin, triglyceride, and baseline eGFR (all P < 0.05). Multivariate analysis identified baseline eGFR and triglyceride as independent predictors of abnormal eGFR by 48 weeks (P < 0.05). CONCLUSION In treatment-naïve patients with CHB, ETV treatment exhibited a strong association with an increased risk of decreased eGFR levels at 48 weeks in comparison with TMF.

Source: World Journal of Hepatology

DOI: 10.4254/wjh.v18.i2.114346