Efficacy of tenofovir dipivoxil plus entecavir in patients with HBeAg positive chronic hepatitis B

Purpose: To investigate the efficacy of tenofovir disoproxil fumarate (TDF) plus entecavir in patients with HBeAg positive chronic hepatitis B. Methods: A total of 124 patients with HBeAg-positive chronic hepatitis who were hospitalized at The First People's Hospital of Jiangxia District, Wuhan, China were chosen as the subjects. They were then randomized equally into study and control groups. Control group received entecavir (0.5 mg orally) while the study group administered TDF (300 mg orally) daily for 48 weeks. Efficacy, liver function, inflammatory factors, liver fibrosis, and adverse reactions between the two groups were evaluated. Results: After 12 weeks of treatment, HBeAg and HBV DNA negative seroconversion rates were significantly higher in the study group compared to control group (p < 0.05). At 24 and 48 weeks after treatment, alanine transaminase (ALT) normalization rate, HBeAg and HBV DNA negative seroconversion rate were also significantly higher compared to control group. Levels of heat shock protein 47 (HSP47), endothelial nitric oxide synthase (eNOS), and major basic protein (MBP) were significantly lower in study group compared to control group. Levels of hyaluronan (HA), type IC collagen (IV-C), N-terminal propeptide of procollagen type III (PIIINP), and laminin (LN) were significantly lower in study group compared to control group (p < 0.05). There was no significant difference in incidence of adverse reactions between the two groups (p > 0 05). Conclusion: The combination of ETV and TDF significantly inhibits hepatitis B virus replication, and reduces inflammatory reactions. Further studies to determine the mechanism of action of tenofovir and entecavir on hepatitis B virus would be required.