Treatment experience of chronic Hepatitis B at the infectious diseases clinic of Çukurova University Faculty of Medicine

Introduction and Objective: Hepatitis B virus is a serious public health problem and, if left untreated, can lead to diseases such as cirrhosis and hepatocellular carcinoma. The goal of treatment is to prevent the progression of the disease by reducing the viral load. This study aimed to review patients treated at our center for chronic hepatitis B and evaluate their treatment regimens. Materials and Methods: The study was conducted on 241 patients who met the inclusion criteria, identified retrospectively from 1835 chronic hepatitis B patients who applied to the Department of Infectious Diseases and Clinical Microbiology at Çukurova University Faculty of Medicine between 2010 and 2023. The patients' demographic data and the laboratory, radiological, and histopathological data identified during follow-up, along with the treatments they received, were retrospectively retrieved from the hospital information system. Subsequently, the 241 patients were divided into two main groups based on their treatment processes: those whose treatment remained unchanged for 5 years and those whose treatment changed after receiving at least 1 year of initial treatment. Results: The mean age of the patients participating in the study was calculated as 48,9±13,3 (25-84), and 125 (51,9 %) of these individuals were male. When patients receiving the same treatment for five years were examined, it was determined that 106 (56.08%) patients received tenofovir disoproxil fumarate and 60 (31,75 %) patients received entecavir treatment. When tenofovir disoproxil fumarate and entecavir treatments were compared, viral suppression was significantly higher in the entecavir group in the first year (p=0,023). Total cholesterol was significantly lower in the tenofovir disoproxil fumarate group in the first year (p=0,044). In the long term, there was no difference between the two treatment groups in terms of virological and biochemical response (p>0,05). In the group of patients who changed treatment, those who switched from tenofovir disoproxil fumarate to tenofovir alafenamide were examined, and no difference in viral load was detected between the two treatments in the tests performed in the first year after switching to tenofovir alafenamide. However, total cholesterol and low-density lipoprotein levels were significantly higher in the tenofovir alafenamide group (p<0,05). Conclusion: Our study has demonstrated that antiviral treatments are largely similar in their efficacy in the management of chronic hepatitis B, but show differences in terms of metabolic effects. Individualized approaches that consider the patient's metabolic profile, comorbidities, and level of liver damage in treatment selection will provide the most appropriate results in terms of both efficacy and safety. Keywords: Entecavir, HBeAg, Chronic Hepatitis B, Tenofovir Alafenamide, Tenofovir Disoproxil Fumarate