{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:17:14Z","timestamp":1788358634173,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 2022 update of Chinese Guidelines for Chronic Hepatitis B (CHB) Management advocates initiating antiviral therapy regardless of alanine aminotransferase (ALT) status in HBV DNA-positive patients aged &amp;gt; 30 years. This study aimed to investigate the virological response and renal safety profile of tenofovir alafenamide (TAF) in this specific population through both short-term (48-week) and extended (96-week) observations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter retrospective cohort study, 122 treatment-na\u00efve CHB patients meeting inclusion criteria from two tertiary hospitals (Yantai Qishan Hospital and Yantai Yuhuangding Hospital) underwent standard TAF monotherapy (25 mg\/day). Serial assessments of virological parameters (HBV DNA quantification) and renal function markers (serum creatinine, estimated glomerular filtration rate) were conducted at baseline, week 48, and week 96.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 48 weeks of TAF treatment, 74.6% of the 122 enrolled patients achieved HBV DNA conversion (HBV DNA &amp;lt; 20 IU\/mL), with the difference in conversion rates being statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Among the 80 patients who completed 96 weeks of follow-up, a progressive increase in HBV DNA conversion rates was observed between week 48 and week 96, demonstrating statistically significant improvement over time (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Intergroup comparisons showed no statistically significant differences, and all safety parameters exhibited no clinically relevant changes during the trial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This real-world evidence demonstrates durable antiviral efficacy of TAF in guideline-defined CHB patients aged &amp;gt; 30 years with normal ALT and active viremia, accompanied by favorable renal tolerability throughout the 96-week treatment period. Extended follow-up is ongoing to establish long-term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1764956","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:28:08Z","timestamp":1784780888000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and safety of tenofovir alafenamide in HBeAg-positive and negative chronic hepatitis B patients aged over 30 years with normal ALT and detectable HBV DNA: a 96-week retrospective two-center study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanfang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Hepatology, Yantai Qishan Hospital","place":["Yantai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Yantai Qishan Hospital","place":["Yantai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Yantai Qishan Hospital","place":["Yantai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Yantai Qishan Hospital","place":["Yantai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youde","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Yantai Qishan Hospital","place":["Yantai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Yantai Yuhuangding Hospital","place":["Yantai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.14218\/JCTH.2023.00320","article-title":"Guidelines for the prevention and treatment of chronic hepatitis B (version 2022).","volume":"11","author":"You","year":"2023","journal-title":"J Clin Transl Hepatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1186\/s12879-024-09103-8","article-title":"The prevalence of hepatitis B in Chinese general population from 2018 to 2022: a systematic review and meta-analysis.","volume":"24","author":"Bai","year":"2024","journal-title":"BMC Infect Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12072-015-9675-4","article-title":"Asian-pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.","volume":"10","author":"Sarin","year":"2016","journal-title":"Hepatol Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1002\/hep.29800","article-title":"Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance.","volume":"67","author":"Terrault","year":"2018","journal-title":"Hepatology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1186\/s12879-024-09617-1","article-title":"Significant liver histological change is common in HBeAg-positive chronic hepatitis B with normal ALT.","volume":"24","author":"Duan","year":"2024","journal-title":"BMC Infect Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1136\/gutjnl-2017-314904","article-title":"High risk of hepatocellular carcinoma and death in patients with immune-tolerant-phase chronic hepatitis B.","volume":"67","author":"Kim","year":"2018","journal-title":"Gut"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1111\/apt.15725","article-title":"Moderate levels of serum hepatitis B virus DNA are associated with the highest risk of hepatocellular carcinoma in chronic hepatitis B patients.","volume":"51","author":"Kim","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"B8","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1186\/s12985-024-02561-1","article-title":"HBeAg-positive CHB patients with indeterminate phase associated with a high risk of significant fibrosis.","volume":"21","author":"Li","year":"2024","journal-title":"Virol J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2479","DOI":"10.3748\/wjg.v29.i16.2479","article-title":"Liver histopathological lesions is severe in patients with normal alanine transaminase and low to moderate hepatitis B virus DNA replication.","volume":"29","author":"Jiang","year":"2023","journal-title":"World J Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e029793","DOI":"10.1136\/bmjopen-2019-029793","article-title":"Mortality trends of liver diseases in mainland China over three decades: an age-period-cohort analysis.","volume":"9","author":"Sun","year":"2019","journal-title":"BMJ Open"},{"key":"B11","doi-asserted-by":"publisher","first-page":"112","DOI":"10.14218\/JCTH.2021.00131","article-title":"Effectiveness of tenofovir alafenamide in chronic hepatitis B patients with normal alanine aminotransferase and positive hepatitis B virus DNA.","volume":"10","author":"Gao","year":"2022","journal-title":"J Clin Transl Hepatol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.14218\/jcth.2023.00272","article-title":"Antiviral therapy favors a lower risk of liver cirrhosis in HBeAg-negative chronic hepatitis B with normal alanine transaminase and HBV DNA positivity.","volume":"11","author":"Zhou","year":"2023","journal-title":"J Clin Transl Hepato."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e78672","DOI":"10.1371\/journal.pone.0078672","article-title":"Significant fibrosis is not rare in Chinese chronic hepatitis B patients with persistent normal ALT.","volume":"8","author":"Liao","year":"2013","journal-title":"PLoS One"},{"key":"B14","doi-asserted-by":"publisher","first-page":"103389","DOI":"10.1016\/j.ebiom.2021.103389","article-title":"A novel nomogram to predict evident histological liver injury in patients with HBeAg-positive chronic hepatitis B virus infection.","volume":"67","author":"Chang","year":"2021","journal-title":"E Bio Medicine"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.1097\/HEP.0000000000000459","article-title":"Antiviral therapy substantially reduces HCC risk in patients with chronic hepatitis B infection in the indeterminate phase.","volume":"78","author":"Huang","year":"2023","journal-title":"Hepatology"},{"key":"B16","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1111\/apt.17052","article-title":"Impact of expanding hepatitis B treatment guidelines: a modelling and economic impact analysis.","volume":"56","author":"Lim","year":"2022","journal-title":"Aliment Pharmacol Ther"},{"key":"B17","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1002\/jmv.22048","article-title":"High prevalence of significant liver fibrosis and cirrhosis in chronic hepatitis B patients with normal ALT in central Europe.","volume":"83","author":"G\u00f6bel","year":"2011","journal-title":"J Med Virol"},{"key":"B18","doi-asserted-by":"crossref","first-page":"358","DOI":"10.5604\/01.3001.0009.8590","article-title":"Cost-effectiveness and clinical impact of antiviral strategies of HBeAg-positive and -negative chronic hepatitis B.","volume":"16","author":"Oyag\u00fcez","year":"2017","journal-title":"Ann Hepatol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"434","DOI":"10.3390\/v14020434","article-title":"Current trend in antiviral therapy for chronic hepatitis B.","volume":"14","author":"Chien","year":"2022","journal-title":"Viruses"},{"key":"B20","doi-asserted-by":"publisher","first-page":"934","DOI":"10.3390\/v12090934","article-title":"The yin and the yang of treatment for chronic hepatitis B-when to start, when to stop nucleos(t)ide analogue therapy.","volume":"12","author":"Hall","year":"2020","journal-title":"Viruses"},{"key":"B21","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1002\/kjm2.12518","article-title":"Finite nucleos(t)ide analogue therapy in hepatitis B e antigen-negative chronic hepatitis B: from an \u201coption\u201d to an \u201cactive recommendation\u201d.","volume":"38","author":"Liaw","year":"2022","journal-title":"Kaohsiung J Med Sci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/S2468-1253(16)30024-3","article-title":"Tenofovir alafenamide versus tenofovir disoproxil fumarate for the treatment of HBeAg-positive chronic hepatitis B virus infection: a randomised, double-blind, phase 3, non-inferiority trial.","volume":"1","author":"Chan","year":"2016","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/S2468-1253(16)30107-8","article-title":"Tenofovir alafenamide versus tenofovir disoproxil fumarate for the treatment of patients with HBeAg-negative chronic hepatitis B virus infection: a randomised, double-blind, phase 3, non-inferiority trial[J\/OL].","volume":"1","author":"Buti","year":"2016","journal-title":"Lancet. Gastroenterol Hepatolo."},{"key":"B24","doi-asserted-by":"publisher","first-page":"427e","DOI":"10.1016\/j.cgh.2021.04.045","article-title":"Tenofovir alafenamide for drug-resistant hepatitis B: a randomized trial for switching from tenofovir disoproxil fumarate.","volume":"20","author":"KSChoi","year":"2022","journal-title":"Clin Gastroenterol Hepatol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1764956\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:28:09Z","timestamp":1784780889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1764956\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":24,"alternative-id":["10.3389\/fmed.2026.1764956"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1764956","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"article-number":"1764956"}}