Biliary HBV relapse rates in patients who discontinue tenofovir disoproxil fumarate with or without switching to tenofovir alafenamide

Background/Aims: The incidence and relapse pattern in patients stopping tenofovir alafenamide (TAF), a prodrug of tenofovir which is more concentrated in hepatocytes, is unknown. Methods: HBeAg-negative CHB patients stopping tenofovir disoproxil fumarate (TDF) (off-TDF) or who had switched to TAF more than 3 months before discontinuation (off-TAF) were recruited. The propensity score-matching method (PSM) was used, creating a ratio of 1:3 between the off-TAF versus the off-TDF groups to adjust for associated factors. Results: After PSM, 180 off-TDF and 60 off-TAF patients were analyzed. The cumulative rates of virolog-ical and clinical relapse at 52 weeks were 75.1% and 58.5% respectively in the off-TDF group and 91.1% and 61.6% in the off-TAF group. Patients in the off-TAF group had significantly higher rates of virological relapse than those in the off-TDF group (p = 0.021), but not clinical relapse (p = 0.785). Multivariate cox regression analysis showed that off-TAF group was an independent factor for virological relapse, but not clinical relapse. Severity of clinical relapse and hepatic decompensation rate were comparable between off-TDF and off-TAF groups Conclusions: The off-TAF group had a higher virological relapse rate than the off-TDF group. The differ-ence in clinical relapse pattern and severity was not clinically important between the two groups. (c) 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study compared the relapse patterns in hepatitis B patients who stopped two different antiviral drugs and found that those who stopped TAF had higher rates of virological relapse, but there was no significant difference in clinical relapse pattern and severity compared to those who stopped TDF.