SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Pharmacology of Infectious Diseases
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1604972
Metabolic effects and cardiovascular disease risks of TDF or TAF in patients with chronic hepatitis B：a systematic review and meta-analysis
Provisionally accepted
- 1Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- 2Department of Infectious Diseases, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
- 3Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- 4Key Laboratory of Infectious Diseases and Parasitic Diseases of Chongqing, Chongqing Medical University, Chongqing, China
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The effects of Tenofovir Disoproxil Fumarate (TDF) or Tenofovir Alafenamide (TAF) on lipid profiles have been observed in chronic hepatitis B (CHB) treatment. However, the metabolic features and their impact on cardiovascular risk remain unclear. We conducted a systematic review and meta-analysis to evaluate these effects.We searched for studies from four major databases (PubMed, Web of Science, EMBASE, and the Cochrane Library) that reported the effects of TDF or TAF on metabolism and cardiovascular disease risk. The changes in metabolic parameters and 10-year atherosclerotic cardiovascular disease (ASCVD) risk were compared with baseline in the TDF and TAF treatment groups. Extracted data were analyzed with the random-effects model or the fixed-effects model. Potential sources of heterogeneity were investigated using sensitivity and subgroup analyses.Results: A total of 19 studies including 19,396 CHB patients (12,067 in TDF-only group, 5423 in TAF-only group, and 1906 in TDF-switched group) were included in this meta-analysis. We found that both TAF and TDF treatment mildly increase the 10year ASCVD risk. The TAF treatment showed significant increases in body weight, with no significant effects were observed on lipid levels or blood glucose. While TDF treatment has a lipid-lowering effect and caused weight loss. Subanalyses emphasized the impact of changing antiviral treatment strategies on metabolism. We found an increased risk of dyslipidemia and body weight gain after switching from TDF to TAF treatment.4 Conclusion: Although TAF and TDF treatments exhibit different metabolic characteristics, both mildly increase the risk of cardiovascular disease.
Keywords: Dyslipidemia, metabolic profile, cardiovascular risk, tenofovir, drug safety, Chronic hepatitis B
Received: 02 Apr 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Zhou, Cai, Chen, Su and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Peng Hu, Department of Infectious Diseases, First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
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