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While F\/TDF lacks activity against hepatitis C virus (HCV), the use of F\/TDF for HIV PrEP may elevate HCV risk through risk compensation. This study aims to investigate HBV\/HCV incidence among men who have sex with men (MSM) using F\/TDF-based HIV PrEP, addressing evidence gaps in low- and middle-income countries.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a secondary analysis of the China Real-World Oral Intake of PrEP (CROPrEP)\u00a0study, a multicenter prospective cohort of MSM (F\/TDF users\/non-users) from Beijing, Shenyang, Shenzhen, and Chongqing. Participants underwent HBV\/HCV testing at baseline and at the 12-month follow-up. Only HBV-susceptible (hepatitis B surface antigen-negative, hepatitis B surface and core antibody-negative) MSM were included in the secondary analysis, to calculate HBV incidence. The primary outcomes were HBV\/HCV incidence rates at the 12-month follow-up. Bayesian Poisson regression identified HBV\/HCV infection risk factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The CROPrEP cohort prospectively recruited 1023 F\/TDF users and 507 F\/TDF non-users at baseline. This secondary analysis included 259 F\/TDF users and 120 non-users identified as HBV-susceptible at baseline. At the 12-month of follow-up, no incident HBV infections occurred in the F\/TDF users group, and only one incident HBV infection occurred in the F\/TDF non-users group. The incidence of new HBV infections was 0.00\/100 person-years (PY) [95% confidence interval (<jats:italic>CI<\/jats:italic>): 0.00<jats:bold>\u2013<\/jats:bold>1.32] among HBV-susceptible F\/TDF users and 0.77\/100 PY (95% <jats:italic>CI:<\/jats:italic> 0.02\u20134.20) among HBV-susceptible F\/TDF non-users. HBV incidence was reduced with F\/TDF compared with no F\/TDF [adjusted incidence rate ratio (aIRR): 0.00; 95% <jats:italic>CI:<\/jats:italic> 0.00\u20130.00]. HCV incidence among F\/TDF users and non-users was 0.31\/100 PY (95% <jats:italic>CI:<\/jats:italic> 0.06\u20130.90) and 0.00\/100 PY (95% <jats:italic>CI:<\/jats:italic> 0.00\u20130.74) after 12\u00a0months, respectively. HCV incidence was lower in F\/TDF non-users than in F\/TDF users (aIRR: 0.00; 95% <jats:italic>CI:<\/jats:italic> 0.00\u20130.25).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study suggests a potential benefit in reducing HBV incidence among MSM using F\/TDF as HIV PrEP, highlighting the potential for integrated prevention strategies addressing both HIV and HBV risks in PrEP programmes.<\/jats:p>\n            <jats:p>\n              <jats:italic>Trial registration<\/jats:italic>: ChiCTR, ChiCTR-IIN-17013762. Registered 8 December 2017, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/showproj.html?proj=22916\" ext-link-type=\"uri\">https:\/\/www.chictr.org.cn\/showproj.html?proj=22916<\/jats:ext-link>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s40249-025-01305-9","type":"journal-article","created":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T02:25:58Z","timestamp":1745720758000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The role of tenofovir-based HIV pre-exposure prophylaxis in preventing HBV infection among men who have sex with men: insights from China"],"prefix":"10.1186","volume":"14","clinical-trial-number":[{"clinical-trial-number":"chictr-iin-17013762","registry":"10.18810\/chictr"}],"author":[{"given":"Zhen-Hao","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Yan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Jie","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Xing","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao-Kai","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Jun","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4303-7295","authenticated-orcid":false,"given":"Hong","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Hai","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"1305_CR1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.eclinm.2018.10.006","volume":"4\u20135","author":"G McKee","year":"2018","unstructured":"McKee G, Butt ZA, Wong S, Salway T, Gilbert M, Wong J, et al. 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