EFFICACY OF TENOFOVIR DISOPROXIL FUMARATE COMPARED WITH ENTECAVIR TO TREAT CHRONIC HEPATITIS B VIRUS MONOINFECTION PATIENTS

Abstract

Objectives: To assess the efficacy among tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in the treatment of chronic hepatitis B monoinfection patients. Material and Methods: A cross sectional analytical study carried out at District Headquarter Hospital Attock at PKLI (Pakistan Kidney and Liver Institute) between January 2019 to July 2020. Total 120 chronic HBV patients with quantitative PCR having DNA viral load > 20,000IU /ml after the treatment failure with any other Nucleos(t)ide Analogues (Lamivudine, Adefovir, Telbivudine) or PEG-IFN (peglyated interferon) were considered. The patients were sorted in two groups, 60 were given TDF (group 1) and 60 were given entecavir (group 2) for a period of 6 months. Follow up carried out after 24 weeks by comparing HBV-DNA levels to compare efficacy between two drugs. Assessment of treatment eligibility for chronic HBV mono-infection is formed by investigating the extent of existing liver disease by ultrasound examination, complete blood count (CBC), liver function tests (LFTs) and Aspartate aminotransferase to platelets ratio index (APRI) score. Results: Range for age of patients was 15~65 years, divided further into three groups 15~19 years 12(10%), 20~60 years 84(70%) and 61~65 years 24(20%). The gender distribution based on these groups was 84(70%) males and 36(30%) females. After 6 months of treatment with TDF / entecavir drugs, compensated liver with better prognosis was showed by TDF 60(50%) and decompensated liver 19(15.8%), cirrhosis 29(24.2%), and fibrosis 12(10%) by entecavir with significant p value <0.001. Post treatment virological response (HBV-DNA levels) at 24 weeks was markedly higher among group 1 (TDF treatment) rather than group 2 (ETV treatment) i.e. 53(88.3%) and 42(70%) respectively. Conclusion: Efficacy of TDF is better than ETV for treatment of chronic HBV monoinfection patients. Key Words: APRI score, Chronic HBV, Entecavir, Tenofovir disoproxil fumarate.