{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:25:24Z","timestamp":1760747124377,"version":"build-2065373602"},"reference-count":21,"publisher":"FapUNIFESP (SciELO)","issue":"9","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to investigate the long-term effects of tenofovir alafenamide, tenofovir disoproxil fumarate, and entecavir on fibrotic burden and to compare the virological clearance and biochemical improvement times achieved with these drugs.  METHODS: The study was designed with treatment-naive, hepatitis B e-antigen-negative chronic hepatitis B patients who started tenofovir alafenamide, tenofovir disoproxil fumarate, or entecavir at a tertiary care hospital. The aspartate aminotransferase-to-platelet ratio index and the fibrosis index based on four factors were used to determine the fibrotic burden.  RESULTS: Age, gender, baseline aspartate aminotransferase-to-platelet ratio index and fibrosis index based on four factors values, and fibrosis grades obtained by the biopsy of patients treated with tenofovir alafenamide (n=45), tenofovir disoproxil fumarate (n=65), and entecavir (n=56) were similar (p&gt;0.05 for all). Significant fibrosis regression was observed during the 5-year antiviral therapy period in the tenofovir alafenamide, tenofovir disoproxil fumarate, and entecavir groups.  CONCLUSION: Significant regression in aspartate aminotransferase-to-platelet ratio index and fibrosis index based on four factors was observed during tenofovir alafenamide, tenofovir disoproxil fumarate, and entecavir therapy within the first 2 years, and this regression remained stable up to the 5th year. None of the three drugs showed superiority over each other in terms of the pattern of fibrosis regression reflected by aspartate aminotransferase-to-platelet ratio index and fibrosis index based on four factors, average virological response time, and biochemical improvement time.<\/jats:p>","DOI":"10.1590\/1806-9282.20250374","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T15:03:49Z","timestamp":1760713429000},"source":"Crossref","is-referenced-by-count":0,"title":["Investigation of the long-term effects of high-potency antiviral agents on aspartate aminotransferase-to-platelet ratio index and fibrosis index based on four factors: five-year outcomes in hepatitis B e-antigen-negative chronic hepatitis B patients"],"prefix":"10.1590","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3362-1044","authenticated-orcid":false,"given":"Mustafa","family":"Arslan","sequence":"first","affiliation":[{"name":"Amasya University,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6756-2724","authenticated-orcid":false,"given":"Ahmet Mert","family":"Cavnar","sequence":"additional","affiliation":[{"name":"Sabuncuo\u011flu \u015eerefeddin Training and Research Hospital,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9878-2554","authenticated-orcid":false,"given":"\u015eirin","family":"\u00c7etin","sequence":"additional","affiliation":[{"name":"Amasya University,  Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"key":"ref1","series-title":"Global hepatitis report, 2017","year":"2017"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1053\/jhep.2000.16602","article-title":"Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the study of the liver (AFEF)","volume":"32","author":"Cadranel JF","year":"2000","journal-title":"Hepatology"},{"issue":"7","key":"ref3","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1056\/NEJM200102153440706","article-title":"Liver biopsy","volume":"344","author":"Bravo AA","year":"2001","journal-title":"N Engl J Med"},{"issue":"2","key":"ref4","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1002\/hep.20535","article-title":"Sources of variability in histological scoring of chronic viral hepatitis","volume":"41","author":"Rousselet MC","year":"2005","journal-title":"Hepatology"},{"issue":"11","key":"ref5","article-title":"A comparative analysis of the APRI, FIB4, and FibroScan score in evaluating the severity of chronic liver disease in chronic hepatitis B patients in India","volume":"13","author":"Rungta S","year":"2021","journal-title":"Cureus"},{"issue":"12","key":"ref6","article-title":"Evaluation of APRI and FIB-4 for noninvasive assessment of significant fibrosis and cirrhosis in HBeAg-negative CHB patients with ALT \u2264 2 ULN: a retrospective cohort study","volume":"96","author":"Li Q","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"ref7","series-title":"Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection","year":"2015"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1111\/j.1365-2036.2008.03895.x","article-title":"The accuracy of the FIB-4 index for the diagnosis of mild fibrosis in chronic hepatitis B","volume":"29","author":"Mallet V","year":"2009","journal-title":"Aliment Pharmacol Ther"},{"issue":"3","key":"ref9","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1002\/hep.23785","article-title":"Long-term entecavir therapy results in the reversal of fibrosis\/cirrhosis and continued histological improvement in patients with chronic hepatitis 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American College of Gastroenterology, and the American Gastroenterological Association","volume":"55","author":"Chalasani N","year":"2012","journal-title":"Hepatology"},{"issue":"1","key":"ref13","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/jgh.15678","article-title":"Long-term effects of entecavir and tenofovir treatment on the fibrotic burden in patients with chronic hepatitis B","volume":"37","author":"Chon YE","year":"2022","journal-title":"J Gastroenterol Hepatol"},{"issue":"1","key":"ref14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4103\/ijp.ijp_851_21","article-title":"Comparison of patients using lamivudine, entecavir, and tenofovir according to liver fibrosis markers fibrosis-4 and aspartate aminotransferase-to-platelet ratio index scores","volume":"55","author":"Okan HD","year":"2023","journal-title":"Indian J Pharmacol"},{"issue":"11-2","key":"ref15","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1111\/apt.18278","article-title":"Eight-year efficacy and safety of tenofovir alafenamide for treatment of chronic hepatitis B virus infection: final results from two randomised phase 3 trials","volume":"60","author":"Buti M","year":"2024","journal-title":"Aliment Pharmacol Ther"},{"issue":"4","key":"ref16","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1053\/j.gastro.2010.06.042","article-title":"Tenofovir and entecavir are the most effective antiviral agents for chronic hepatitis B: a systematic review and Bayesian meta-analyses","volume":"139","author":"Woo G","year":"2010","journal-title":"Gastroenterology"},{"issue":"4","key":"ref17","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.jhep.2015.11.012","article-title":"Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients","volume":"64","author":"Kim WR","year":"2016","journal-title":"J Hepatol"},{"issue":"3","key":"ref18","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/jcph.409","article-title":"A meta-analysis comparing the efficacy of entecavir and tenofovir for the treatment of chronic hepatitis B infection","volume":"55","author":"Zuo SR","year":"2015","journal-title":"J Clin Pharmacol"},{"issue":"1","key":"ref19","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12876-017-0596-7","article-title":"Comparison of the long-term efficacy between entecavir and tenofovir in treatment- na\u00efve chronic hepatitis B patients","volume":"17","author":"Park JW","year":"2017","journal-title":"BMC Gastroenterol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.intimp.2016.11.022","article-title":"The efficacy and safety comparison between tenofovir and entecavir in treatment of chronic hepatitis B and HBV related cirrhosis: a systematic review and Meta-analysis","volume":"42","author":"Han Y","year":"2017","journal-title":"Int Immunopharmacol"},{"issue":"1","key":"ref21","first-page":"124","article-title":"Comparison of the effects of Tenofovir Disoproxil Fumarate (TDF) and Tenofovir Alafenamide (TAF) on liver function in patients with hepatitis B: a meta-analysis","volume":"31","author":"Chen L","year":"2025","journal-title":"Altern Ther Health Med"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302025000900609&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T15:03:52Z","timestamp":1760713432000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302025000900609&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":21,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0104-42302025000900609"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20250374","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e20250374"}}