Tenofovir alafenamide (TAF) treatment of HBV, what are the unanswered questions?

Mauro Viganò, Alessandro Loglio, Glenda Grossi, Pietro Lampertico

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Introduction: Tenofovir disoproxil fumarate (TDF), an ester prodrug of tenofovir (TFV), is one of the recommended drugs for chronic hepatitis B (CHB) patients. However, reduced kidney function and loss of bone mineral density have been reported in some CHB patients treated with TDF. Consequent to these safety issues, tenofovir alafenamide (TAF) [Vemlidy®], a phosphonate prodrug of TFV, was developed for the treatment of CHB patients. Areas covered: The favourable pharmacological profile of TAF allows a marked reduction in dosage (25 mg/day) thus reducing systemic exposure to tenofovir and improving the bone and renal safety, keeping however the same virological efficacy, compared to TDF 300 mg/day. In two ongoing 96-week phase III trials in mainly treatment-naive HBeAg-positive or -negative patients, TAF showed similar viral suppression but was associated with significantly higher alanine aminotransferase normalization rates and more favourable renal and bone safety compared to TDF. In a 48-week TAF switch study enrolling patients treated with TDF for 96 weeks, glomerular, tubular and bone safety parameters rapidly improved while virological suppression was maintained. Expert commentary: Waiting long-term large scale clinical practice studies aimed to confirm these advantages, TAF represents an helpful treatment option for both naïve and TDF-exposed CHB patients.

Original languageEnglish
Pages (from-to)153-161
Number of pages9
JournalExpert Review of Anti-Infective Therapy
Volume16
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

Fingerprint

Tenofovir
Chronic Hepatitis B
Safety
Therapeutics
Prodrugs
Kidney
Bone and Bones
GS-7340
Organophosphonates
Fumarates
Hepatitis B e Antigens

Keywords

  • Antiviral therapy
  • HBV
  • hepatitis B virus
  • kidney
  • safety
  • tenofovir alafenamide (TAF)

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

Cite this

Tenofovir alafenamide (TAF) treatment of HBV, what are the unanswered questions? / Viganò, Mauro; Loglio, Alessandro; Grossi, Glenda; Lampertico, Pietro.

In: Expert Review of Anti-Infective Therapy, Vol. 16, No. 2, 01.02.2018, p. 153-161.

Research output: Contribution to journalReview article

Viganò, Mauro ; Loglio, Alessandro ; Grossi, Glenda ; Lampertico, Pietro. / Tenofovir alafenamide (TAF) treatment of HBV, what are the unanswered questions?. In: Expert Review of Anti-Infective Therapy. 2018 ; Vol. 16, No. 2. pp. 153-161.
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