Application of EASL 2017 criteria for switching hepatitis B patients from tenofovir disoproxil to entecavir or tenofovir alafenamide

Luisa Roade, Alessandro Loglio, Marta Borghi, Mar Riveiro-Barciela, Roberta Soffredini, Floriana Facchetti, Dhanai di Paolo, David Tabernero, Giovanna Lunghi, Rafael Esteban, Maria Buti, Pietro Lampertico

Research output: Contribution to journalArticlepeer-review


Background: To overcome safety limitations of tenofovir-disoproxil, EASL guidelines proposed switching chronic hepatitis B patients older than 60 years or with bone or renal disease to tenofovir-alafenamide or entecavir. Aims: To estimate the number of patients who would benefit from a treatment switch in a real-life setting. Methods: Consecutive hepatitis B patients receiving tenofovir-disoproxil before 31 December 2017 were enrolled in a cross-sectional study in two European hospitals. Clinical and virological data were recorded; renal function was assessed by estimated glomerular filtrate rate, serum phosphate and creatinine, proteinuria, and albuminuria; bone involvement by spine and femur DEXA scan. Results: In total, 565 patients included: 62 (18–91) years, 75% males, 92% Caucasian, 92% HBeAg-negative, 40% cirrhotic. Fifty-five percent of patients fulfilled age criterion (>60 years). Older patients had higher rates of cirrhosis (51% vs 26%, p<0.001), cardiovascular disease, and renal impairment. Thirty-six percent of patients met renal criteria, more commonly NA-experienced individuals (35% vs 21%, p=0.001); 17% had bone disease. Overall, 66% of patients had at least one criterion (71% if NA-experienced), 8% all three criteria, 28% age and renal criteria. Conclusions: Approximately two-thirds of patients receiving long-term tenofovir-disoproxil are candidates for an entecavir or tenofovir-alafenamide switch according to EASL recommendations

Original languageEnglish
Pages (from-to)1164-1169
JournalDigestive and Liver Disease
Issue number10
Publication statusPublished - 2020


  • Bone safety
  • ETV
  • HBV
  • Nucleos(t)ide analogues
  • Renal safety
  • TAF
  • TDF

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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