HBV relapse sooner, more severe after stopping TDF vs ETV

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Takeaway

  • HBV relapse is more common and severe, and tends to occur earlier, among patients discontinuing tenofovir disoproxil fumarate (TDF) vs entecavir (ETV).

Why this matters

  • Patients should be closely monitored in the 6 months following TDF discontinuation.

Study design

  • Retrospective-prospective study of patients with chronic HBV stopping ETV (n=342) or TDF (n=165) and followed for ≥6 months.
  • 68.4% and 72.1% of ETV- and TDF-treated patients, respectively, were negative for HBV envelope antigen (HBeAg).
  • Funding: Ministry of Science and Technology of the Republic of China, Chang Gung Memorial Hospital.    

Key results

  • Virologic relapse rates were higher and earlier after TDF vs ETV:
    • HBeAg+: 3 months, 28.3% vs 5.6%; 6 months, 56.5% vs 13.0%; 2 years, 72.4% vs 41.3% (all P<.001>
    • HBeAg: 3 months, 20.2% vs 5.6%; 6 months, 45.4% vs 29.1% (both P<.001 years vs>
  • Clinical relapse rates were higher and earlier after TDF vs ETV:
    • HBeAg+: 6 months, 32.6% vs 5.6%; 2 years, 63.5% vs 33.0% (both P<.001>
    • HBeAg: 6 months, 27.0% vs 10.3% (P<.001 years vs>
  • Stopping TDF predicted virologic and clinical relapse vs ETV in HBsAg+ (HR=3.335, 2.671; both P<.001 and hbeag>– patients (HR=1.627 [P=.001], HR=1.425 [P=.028]).

Limitations

  • Observational design.