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SYSTEMATIC REVIEW article

Front. Pharmacol.
Sec. Pharmacology of Infectious Diseases
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1507117

Efficacy and Safety of Tenofovir and Entecavir in Patients with Chronic Hepatitis B-Related Cirrhosis: A Systematic Review and Meta-analysis

Provisionally accepted
Lu Cao Lu Cao Li Li Li Li *Lixing Yang Lixing Yang *Nan Zhou Nan Zhou *Yu Zhang Yu Zhang *
  • Shaanxi Provincial People's Hospital, Xi'an, China

The final, formatted version of the article will be published soon.

    Objectives: To systematically evaluate the efficacy and safety of tenofovir and entecavir in chronic hepatitis B-related cirrhosis. Methods: A comprehensive search was conducted in databases including PubMed, Web of Science, Embase and Cochrane Library from the inception until June 2024. Studies on the use of tenofovir and entecavir for chronic hepatitis B-related cirrhosis were collected. Results: A total of 14 studies involving 14,208 patients were included. The meta-analysis revealed that tenofovir significantly reduced the cumulative incidence of hepatocellular carcinoma and cumulative mortality compared to entecavir in East Asian popupation, while in non East Asian populations, the two groups are roughly equivalent. After 48 weeks, the hepatitis B virus-deoxyribonucleic acid clearance rate in the tenofovir group were comparable to the entecavir group. Both tenofovir and entecavir showed similar effect in reducing the incidence of hepatic encephalopathy. Compared with the entecavir group, patients in the tenofovir group, including tenofovir disoproxil fumarate and tenofovir alafenamide fumarate showed a significant increase in estimated glomerular filtration rate after 48 weeks of treatment. Conclusion: Compared to entecavir, tenofovir significantly reduced the cumulative incidence of hepatocellular carcinoma and cumulative mortality in chronic hepatitis B-related cirrhosis in East Asian population.However, both drugs were comparable in terms of hepatitis B virus-deoxyribonucleic acid clearance and hepatic encephalopathy. Tenofovir did not significantly cause renal dysfunction, but instead improved estimated glomerular filtration rate levels compared with entecavir. Randomized controlled trials with larger sample size are still needed for validation.Trial Registration: PROSPERO CRD42024588432.

    Keywords: Not avaliable Clinical trial registration: Not avaliable Meta-analysis, tenofovir, entecavir, Chronic hepatitis B, Cirrhosis. Chronic Hepatitis B Virus (HBV) infection represents a significant global public health concern, with an

    Received: 09 Oct 2024; Accepted: 03 Jan 2025.

    Copyright: © 2025 Cao, Li, Yang, Zhou and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Li Li, Shaanxi Provincial People's Hospital, Xi'an, China
    Lixing Yang, Shaanxi Provincial People's Hospital, Xi'an, China
    Nan Zhou, Shaanxi Provincial People's Hospital, Xi'an, China
    Yu Zhang, Shaanxi Provincial People's Hospital, Xi'an, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.