Evaluation Effect of Tenofovir Alafenamide (TAF) in Long-Term Therapy for Chronic Hepatitis B: A Systematic Review

Rada Citra Saputra(1), Nur Hidayat(2),


(1) Faculty of Medicine, University of Muhammadiyah Surakarta, Solo
(2) Department of Internal Medicine, Faculty of Medicine, University of Muhammadiyah Surakarta
Corresponding Author

Abstract


Background: Tenofovir alafenamide (TAF) is phosphonamidate prodrug of tenofir that inhibits hepatitis B virus and HIV type-1 reverse transcription. TAF more stable form in plasma than tenofovir disoproxil fumarate (TDF) as choice treatment before. TAF in long-term treatment also significantly reduced bone mineral density (BMD) and raised serum creatinine, as well as improved markers of renal tubular function. This study aims to review the long-term therapy of TAF effect in body weight gain, BMD, renal function, lipids profile, ALT normalization, and HBeAg loss.

Method: The data was taken from Pubmed, ScienceDirect, and Cochrane Library. We found 363 articles from databases. The articles related to long-term therapy in chronic hepatitis-B and adjusted according to restriction criteria. Articles selection using PRISMA flowchart and quality test using GRADE method into eligible articles.

Results: We selected articles that eligible for systematic review with different GRADE recommendation which were 4 high-grade articles, 1 low-grade, and 1 very low-grade article. TAF in long-term therapy showed an increase in BMD (p < 0.001), body weight gain (p < 0.001), decreased renal dysfunction (CrCl; p < 0.0001 and GFR; p = 0.027), and normalized ALT (p = 0.016). However, lipids profile level increase that could increase risk of atherosclerosis and dyslipidemia. There was no significant in HBeAg loss.

Conclusion: TAF therapy is favourable therapy in long-term therapy of chronic hepatitis B patients by smaller reduce of BMD, and significant body weight gain, reduce renal dysfunction, good improvement in lipid profile and improving ALT enzymes.


Keywords


tenofovir alafenamide; long-term therapy; chronic; hepatitis B

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DOI: 10.24871/2332022217-226

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