D0476 - Tenofovir Disoproxil Fumarate Switching to Tenofovir Alafenamide for Three Years Resulted in Improvement of Hepatic Fibrosis by APRI and FIB-4 Score as Well as Shear Wave Elastography in Patients With Chronic Hepatitis B
University of California Irvine Medical Center Orange, CA
Tung Huynh, PharmD1, Ke-Qin Hu, MD2 1University of California Irvine Health, Orange, CA; 2University of California Irvine Medical Center, Orange, CA
Introduction: Tenofovir Alafenamide (TAF) is one of the first-line treatments (Rx) for chronic hepatitis B (CHB) with comparable antiviral effects, better safety profile than Tenofovir Disoproxil Fumarate (TDF). We have showed switching from TDF to TAF Rx for 96 weeks resulted in further ALT improvement, but data remain lacking on its long-term effects on hepatic fibrosis. The present study assessed effects of TDF switching to TAF for 3 years (144 weeks) on AST to Platelet Ratio Index (APRI), Fibrosis-4 (FIB-4) scores, and shear wave elastography (SWE).
Methods: A single center retrospective study on 53 CHB patients initially treated with TDF, then switched to TAF to determine patterns of ALT, AST, APRI, FIB-4 scores, SWE improvement at Rx week (Rx wk) 144, and the associated factors.
Results: Mean age 55 (28-80); 7.7%, spleen size >12 cm; 11.3%, platelets < 120 x109/L; mean baseline ALT, 24.8 (7-108); AST, 25.7 (15-89) IU/L; APRI, 0.37 (0.13-0.92); FIB-4, 1.66 (0.49-5.33). After switching, means of ALT, AST, APRI, and FIB-4 were all improved persistently. Mean ALT was reduced to 20.8 (8-106), 19.1 (7-40), 19.5 (9-42), 19.7 (8-42) (Fig.1A); mean AST, 21.4 (13-59), 20.3 (14-38), 21.2 (13-41), 21 (13-39) (Fig.1B); mean APRI, 0.29 (0.09-0.78), 0.28 (0.12-0.69), 0.28 (0.13-0.64), 0.27 (0.11-0.51) (Fig.1C); mean FIB-4, 1.43 (0.39-3.94), 1.46 (0.49-3.68), 1.43 (0.50-3.33), 1.38 (0.39-2.76) (Fig.1D); at Rx wk 24, 48, 96, 144, respectively. Mean SWE reading was improved from 7.05 to 6.30 kilopascal (kPa), improvement rate to fibrosis stage 0-1 was increased from 32/50 (64%) to 43/50 (86%) after a mean of 108 wks switching (4-240). Univariate analysis showed pre-Rx spleen >12 cm (p=0.031); platelet < 120 x109/L (p=0.018), APRI < 0.5 (p=0.047), but not FIB-4 < 1.45 (p=0.055), ALT < 40 (p=0.460), AST < 40 (p=0.460) at Rx wk 24 were associated with SWE improvement. Multivariate analysis showed hepatic fibrosis improvement by SWE was negatively associated with pre-Rx spleen >12 cm (p=0.016), independently to platelet < 120 x109/L (p=0.250), APRI < 0.5 (p=0.448), and FIB-4 < 1.45 (p=0.244) at Rx wk 24.
Discussion: Our data confirmed switching from TDF to TAF for 3 years results in not only persistent ALT, AST improvement, but also hepatic fibrosis improvement by APRI, FIB-4, as well as by SWE reading. SWE improvement was significantly negatively associated with pre-Rx spleen >12 cm, independent to platelet < 120 x109/L, APRI < 0.5, and FIB-4 < 1.45 at Rx wk 24.
Figure: Dynamic changes in mean reduction of ALT, AST, APRI, and FIB-4 scores from baseline to treatment week 144 after TDF switching to TAF
Disclosures:
Tung Huynh indicated no relevant financial relationships.
Ke-Qin Hu indicated no relevant financial relationships.
Tung Huynh, PharmD1, Ke-Qin Hu, MD2. D0476 - Tenofovir Disoproxil Fumarate Switching to Tenofovir Alafenamide for Three Years Resulted in Improvement of Hepatic Fibrosis by APRI and FIB-4 Score as Well as Shear Wave Elastography in Patients With Chronic Hepatitis B, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.
