Efficacy and safety of entecavir and tenofovir in patients with chronic hepatitis B virus infection: a meta-analysis

Abstract

Objective To compare the efficacy and safety of tenofovir (TDF) and entecavir (ETV) in patients with chronic hepatitis B (CHB). Methods Studies that compared the treatment efficacy and safety between TDF and ETV in CHB patients were searched through electronic databases before Mar 2015. Alanine aminotransferase (ALT) normalization rate, hepatitis B virus (HBV) DNA suppression rate, hepatitis B e antigen (HBeAg) seroconversion rate, drug resistance rate and safety profile were reviewed. RevMan 5.2 was used for analysis. Results A total of 13 studies met inclusion criteria and 1 934 patients were analyzed, including 884 patients treated with TDF and 1 050 with ETV. The HBV DNA suppression rate of TDF was superior to ETV at week 48 (OR=1.36, 95%CI: 1.05-1.76, P=0.02). The ALT normalization rate of ETV was superior to TDF at week 24 (OR=0.68, 95%CI: 0.48-0.96, P=0.03). The virological response at week 24, ALT normalization rate at week 48 and serological response at week 24 and 48 were not significantly different between patients treated with TDF and ETV (all P>0.05). The resistance rate was not significantly different between patients treated with TDF and ETV 24 months after treatment (P=0.51). And the safety profiles of these two drugs were similar (P>0.05). Conclusions TDF has better virological response compared with ETV. The drug resistance rate and safety profile are similar between TDF and ETV. Key words: Hepatitis B, chronic; Entecavir; Tenofovir; Meta-analysis