Risk of dyslipidemia in chronic hepatitis B patients taking tenofovir alafenamide: a systematic review and meta-analysis

Hwang, Eui Gwon; Jung, Eun-Ae; Yoo, Jeong‐Ju; Kim, Sang Gyune; Kim, Young Seok

doi:10.1007/s12072-023-10528-7

Cited by 8 publications

(8 citation statements)

References 49 publications

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“…Recent metaanalyses and large-scale studies involving CHB patients treated with TAF have reaffirmed the previously known lipid-elevating effects of TAF treatment in PWH. 11,17,18,23,24 Additionally, a recent prospective study reported increases in body weight and metabolic disturbances following a switch from TDF to TAF. 25 However, some limitations remain owing to the lack of key confounders and control groups.…”

Section: Discussionmentioning

confidence: 99%

Metabolic effects and cardiovascular disease risks of antiviral treatments in patients with chronic hepatitis B

Shin,

Lim,

Yoon

et al. 2024

Journal of Medical Virology

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Different antiviral treatments for chronic hepatitis B (CHB) have been known to have different metabolic effects. This study aimed to reveal whether tenofovir alafenamide (TAF)‐induced dyslipidemia and its associated outcomes are significant. This study utilized 15‐year historical cohort including patients with CHB in Korea and consisted of two parts: the single‐antiviral and switch‐antiviral cohorts. In the single‐antiviral cohort, patients were divided into four groups (entecavir [ETV]‐only, tenofovir disoproxil fumarate [TDF]‐only, TAF‐only, and non‐antiviral). Propensity score matching (PSM) and linear regression model were sequentially applied to compare metabolic profiles and estimated atherosclerotic cardiovascular disease (ASCVD) risks longitudinally. In the switch‐antiviral cohort, pairwise analyses were conducted in patients who switched NAs to TAF or from TAF. In the single‐antiviral cohort, body weight and statin use showed significant differences between groups before PSM, but well‐balanced after PSM. Changes in total cholesterol were significantly different between groups (−2.57 mg/dL/year in the TDF‐only group and +2.88 mg/dL/year in the TAF‐only group; p = 0.002 and p = 0.02, respectively). In the TDF‐only group, HDL cholesterol decreased as well (−0.55 mg/dL/year; p < 0.001). The TAF‐only group had the greatest increase in ASCVD risk, followed by the TDF‐only group and the non‐antiviral group. In the switch‐antiviral cohort, patients who switched from TDF to TAF had a higher total cholesterol after switching (+9.4 mg/dL/year) than before switching (−1.0 mg/dL/year; p = 0.047). Sensitivity analysis on data with an observation period set to a maximum of 3 years for NA treatment showed consistent results on total cholesterol (−2.96 mg/dL/year in the TDF‐only group and +3.09 mg/dL/year in the TAF‐only group; p = 0.001 and p = 0.005, respectively). Another sensitivity analysis conducted on statin‐treated patients revealed no significant change in cholesterol and ASCVD risk. TAF was associated with increased total cholesterol, whereas TDF was associated with decreased total and HDL cholesterol. Both TAF and TDF were associated with increased ASCVD risks, and statin use might mitigate these risks.

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Section: Discussionmentioning

confidence: 99%

Metabolic effects and cardiovascular disease risks of antiviral treatments in patients with chronic hepatitis B

Shin,

Lim,

Yoon

et al. 2024

Journal of Medical Virology

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“…44 Thirdly, while side effects of long-term use of oral antiviral agents are rare, they can be challenging, particularly in patients with comorbidities such as metabolic disorders. 45…”

Section: Treating All Hbsag-positive Patients Helped Reduce Hbv-relat...mentioning

confidence: 99%

“Treat-all” Strategy for Patients with Chronic Hepatitis B Virus Infection in China: Are We There Yet?

Zhang,

Kong,

et al. 2024

J Clin Transl Hepatol

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“…With sincere interest, we have carefully reviewed the article “Risk of dyslipidemia in chronic hepatitis B patients taking tenofovir alafenamide: a systematic review and meta-analysis,” published in your esteemed journal by Hwang et al [ 1 ]. This meta-analysis revealed that individuals receiving the tenofovir alafenamide(TAF) regimen demonstrated notably higher elevations in various lipid parameters.…”

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confidence: 99%

“…As outlined in the meta-analysis, the enrolled studies comprised two randomized controlled trials (RCTs), three prospective cohorts, and seven retrospective cohorts. Notably, the I 2 statistic exceeded 45% for all the results, and the majority (26 out of 28) were with 80% and above I 2 statistics (refer to Table 2–4) [ 1 ]. Previous studies proposed that an I 2 surpassing 75% indicated high heterogeneity [ 2 ], while 50% suggested a significant heterogeneity [ 3 ].…”

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Comments on: Risk of dyslipidemia in chronic hepatitis B patients taking tenofovir alafenamide: a systematic review and meta-analysis

Wang,

Sun,

Zhang

et al. 2024

Hepatol Int

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Risk of dyslipidemia in chronic hepatitis B patients taking tenofovir alafenamide: a systematic review and meta-analysis

Cited by 8 publications

References 49 publications

Metabolic effects and cardiovascular disease risks of antiviral treatments in patients with chronic hepatitis B

Metabolic effects and cardiovascular disease risks of antiviral treatments in patients with chronic hepatitis B

“Treat-all” Strategy for Patients with Chronic Hepatitis B Virus Infection in China: Are We There Yet?

Comments on: Risk of dyslipidemia in chronic hepatitis B patients taking tenofovir alafenamide: a systematic review and meta-analysis

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