Evaluation of the Efficacy of Tenofovir Alafenamide in Patients with Low-Level Viremia Under Chronic Hepatitis B Treatment

In a multicenter, retrospective study of 62 patients, we aimed to investigate whether switching from entecavir (ETV) or tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) is a superior treatment strategy for patients with chronic hepatitis B (CHB) experiencing low-level viremia (LLV). The study found that TAF significantly improved virological and biochemical outcomes. At 48 weeks, the sustained virological response was 77.8% for those who switched from ETV and 81.8% for those who switched from TDF, with HBV DNA negativity reaching 81% by month 12. Significant normalization of liver enzymes, albumin, and platelets was also observed. While switching from TDF was associated with a significant increase in triglycerides and HDL and a decrease in eGFR, no such changes were noted in the ETV group. This evidence suggests that TAF provides better virological control, promotes the regression of liver fibrosis, and may reduce the risk of hepatocellular carcinoma (HCC), making it a more advantageous option than continuing prior monotherapy.