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Infectious Disease4 papers

Chronic aggressive type B viral hepatitis

Last edited: 4/10/2026

Overview

Chronic hepatitis B (CHB) is a condition for which high-genetic barrier nucleos(t)ide analogues are established treatments 1. This summary focuses on the comparative efficacy of these treatments in treatment-naïve CHB patients 1.

Management

  • Four high-genetic barrier nucleos(t)ide analogues (NAs) are established for chronic hepatitis B (CHB): entecavir (ETV), tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), and besifovir dipivoxil maleate (BSV) 1.
  • TDF demonstrates superior virologic response compared to ETV at both 48 and 96 weeks in treatment-naïve CHB patients 1.
  • ETV is ranked first for 48-week biochemical response and outperforms TDF 1.
  • Key Recommendations

  • For treatment-naïve chronic hepatitis B patients, tenofovir disoproxil fumarate (TDF) is recommended over entecavir (ETV) for achieving superior virologic response at 48 and 96 weeks 1. (Evidence: Strong)
  • Entecavir (ETV) may be considered for optimizing biochemical response at 48 weeks, as it demonstrated superiority over tenofovir disoproxil fumarate (TDF) in this outcome 1. (Evidence: Strong)
  • References

    1 Lee J, Lee A, Sung PS, Jang JW, Bae SH, Choi JY et al.. Efficacy comparison of high-genetic barrier nucleos(t)ide analogues in treatment-naïve chronic hepatitis B patients: a network meta-analysis. The Korean journal of internal medicine 2024. link

    Original source

    1. [1]
      Efficacy comparison of high-genetic barrier nucleos(t)ide analogues in treatment-naïve chronic hepatitis B patients: a network meta-analysis.Lee J, Lee A, Sung PS, Jang JW, Bae SH, Choi JY et al. The Korean journal of internal medicine (2024)

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