Efficacy and safety of tenofovir alafenamide versus tenofovir disoproxil fumarate in treatment‐naïve chronic hepatitis B

Background and Aims We used real‐world data to evaluate the efficacy and safety of tenofovir alafenamide (TAF) compared with tenofovir disoproxil fumarate (TDF) in treatment‐naïve patients with CHB. Methods We analysed 2747 patients with CHB under TAF (n = 502) or TDF (n = 2245) treatments. Virological responses (VR: HBV DNA 0.05 for all). Normalized ALT, as determined by local laboratory criteria ( 0.05 for all). The HCC risk did not statistically differ across the entire cohort or in the PS‐matched cohort. The TAF group showed a lower median increase in serum creatinine from baseline during the early study period. Compared with the TAF, the TDF group showed significant decreases in total cholesterol, triglyceride and HDL, but not in LDL. Conclusions Real‐word data indicate that TAF has comparable efficacies to TDF in terms of VR and ALT normalization, with no higher risk of HCC.