A comparison between entecavir and tenofovir in chronic hepatitis B in the clinical practice: a single-center experience

Chronic Hepatitis B (CHB) affects 350-400 million of patients worldwide. Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are two nucleoside/nucleotide analogs recommended as first-line treatments in CHB. This retrospective study aimed at comparing effectiveness and renal safety of ETV and TDF through the analysis of data obtained from our CHB outpatients from June 2007 to September 2014. 41 out of 126 CHB outpatients were treated with ETV and 18 with TDF. TDF showed greater, though not statistically significant, effectiveness, in the three groups considered, i.e. naïve, pretreated with nucleoside/nucleotide analogs other than ETV or TDF, and pretreated with ETV or TDF patients. In particular, in naïve patients, those treated with TDF attained not detectable levels of viremia more rapidly (7 months versus 9 months) than ETV-treated patients, even starting from higher HBV DNA levels. In addition, virologic failure was observed in 0 versus 11% in TDF and ETV group, respectively. Also in patients pretreated with nucleoside/nucleotide analogs other than ETV or TDF, virologic failure was observed just in ETV patients. In patients who switched from ETV or TDF the mean time to attain undetectable HBV DNA levels was shorter in TDF group (3 months versus 6 months). Considering renal toxicity, there was no difference in creatinine and GFR levels between the two groups. Proteinuria and phosphaturia were greater in TDF patients, reaching statistical significance just in those pretreated with nucleoside/nucleotide analogs other than ETV or TDF