Abstract: Objective The aim of this study was to observe antiviral efficacy and impacts on bone mineral density and renal functions of tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) in the treatment of patients with chronic hepatitis B (CHB). Methods A total of 202 patients with CHB were enrolled in our health management center between January 2022 and January 2024, and were randomly assigned to receive oral TAF in 101 cases or TDF in another 101 cases. Observation lasted for 12 months. Serum HBeAg, HBsAg, and hyaluronic acid (HA), IV collagen (IV-C), type III procollagen peptide (PC-III) and laminin (LN) levels were detected by ELISA. Serum HBV DNA loads were detected by real-time fluorescence quantitative PCR. Bone mineral density was determined by dual-energy X-ray absorptiometry scanner, and glomerular filtration rate (GFR) was calculated based on CKD-EPI formula. Results By the end of 12 months of treatment, serum HBV DNA turned to undetectable, and serum AST and ALT levels normalized in the two groups; there were no significant differences as respect to serum HA, IV-C, PC-III and LN levels in the two groups (P>0.05); incidence of decreased bone mineral density and GFR in TAF-treated patients was 2.0%, much lower than 10.9% (P<0.05) in TDF-treated patients. Conclusion The antiviral efficacy of TAF and TDF is parallel in the treatment of patients with CHB, and their impact on bone mineral density and GFR needs long-term clinical observation.

Key words: Hepatitis B, Tenofovir alafenamide fumarate, Tenofovir disoproxil fumarate, Bone mineral density, Glomerular filtration rate, Therapy