İnvestigation of metabolic parameters in chronic hepatitis B patients who havechanged antiviral treatment

INTRODUCTION AND OBJECTIVE: Chronic hepatitis B (CHB) infection is important for public health due to complications it is associated with. Our research aimed to examine the reasons for treatment changes made during the follow-up of cases receiving CHB treatment and treatment responses after the change. METHODS: The reason for the treatment change of the cases, AST, ALT, platelet, creatinine, GFR, phosphorus and HBV DNA levels, APRI score and lipid profile at 6, 12, 24 and 48 months after the change were recorded retrospectively. RESULTS: The most common reason for medication changes is osteoporosis, and medication changes due to drug intolerance were made more frequently in those using telbivudine (TBV). After drug change, the decrease in ALT is significant in those taking tenofovir alafenamide fumarate (TAF) and entecavir (ETV) compared to those taking tenofovir disoproxil fumarate (TDF). While the decrease in APRI is evident in the 12th and 24th months in those switching from TDF to TAF, it is evident in the 24th and 48th months in those switching from TDF to ETV. An increase in GFR is observed in those receiving TDF. While an increase in LDL was observed in the 24th month in TAF users, this difference did not continue in the 48th month. CONCLUSION: TAF and ETV were found to be more effective than TDF in reducing ALT. It is important to examine the long-term effects of treatment modifications on clinical outcomes in more detail and to carefully monitor patients for potential side effects during antiviral therapy, making treatment modification decisions on a case-by-case basis. Keywords: Antiviral treatment modification, ALT, Chronic Hepatitis B, Drug resistance