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Tenofovir disoproxil fumarate significantly decreases serum lipoprotein levels compared with entecavir nucleos(t)ide analogue therapy in chronic hepatitis B carriers
Author(s) -
Shaheen A. A.,
AlMattooq M.,
Yazdanfar S.,
Burak K. W.,
Swain M. G.,
Congly S. E.,
Borman M. A.,
Lee S. S.,
Myers R. P.,
Coffin C. S.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14218
Subject(s) - medicine , entecavir , dyslipidemia , gastroenterology , diabetes mellitus , hbeag , propensity score matching , hepatitis b , hepatitis b virus , endocrinology , immunology , disease , lamivudine , virus , hbsag
Summary Background Tenofovir disoproxil fumarate ( TDF ) and entecavir ( ETV ) are first‐line treatments for chronic hepatitis B ( CHB ). Studies suggest lipid lowering effect of TDF in human immunodeficiency virus positive ( HIV +) individuals, but the effect on lipids and cardiovascular disease ( CVD ) risk in CHB is unknown. Aim To compare TDF vs ETV effects on lipid levels in CHB . Methods In this retrospective cohort study, data on serum lipids and CVD risk factors at baseline and ~1 year on TDF or ETV were collected from CHB carriers. We used propensity score matched models to assess the effect on total cholesterol ( TC ), LDL ‐C, HDL and triglycerides ( TGL ). Results In 348 patients, median age was 57 ( IQR : 47‐65 years), 63% were male, 77% were Asian, 19% were cirrhotic, 25% were HB eAg positive at baseline, and 72% received TDF vs 28% ETV . ETV ‐treated patients were older (median age: 60 vs 55, P <.01), had similar smoking and hypertension rates, but diabetes and dyslipidemia were more prevalent (19% vs 9%, P =.01; 14% vs 6%, P =.05, respectively). In propensity score matched models for age, gender, usage of lipid lowering agents, dyslipidemia and diabetes, TDF ‐treated patients were more likely to show a 20% decrease in TC (95% CI : 3%‐25%), LDL ‐C (95% CI : 1%‐25%) and HDL ‐C ( CI : 10%‐30%) levels compared with those on ETV . No change in TGL was observed in either group. Conclusions A greater decline in TC , LDL ‐C and HDL was observed in CHB carriers receiving TDF compared with ETV . These data may influence anti‐viral choice in CHB carriers at risk for CVD .