REAL-WORLD DATA OF TENOFOVIR ALAFENAMIDE IN TREATMENT-NAIVE AND EXPERIENCED PATIENTS WITH CHRONIC HEPATITIS B: MORE EFFICACY, LESS SIDE EFFECTS

Background: Tenofovir alafenamide (TAF) has fewer safety concerns and similar antiviral efficacy compared to entecavir (ETV) and tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB). We aim to pres-ent efficacy and safety data of TAF in the real-world patients. Methods: This is a retrospective study of patients (aged above 18 years) with CHB (HBeAg +/-) who have used TAF for at least 6 months. Longitudinal virological and biochemical tests were performed at intervals. HBV DNA level <31.6 IU/mL for virologicalresponse, serum phosphorus (Pi) level <2.5 mg/dl for hypophosphatemia, eGFR <60 mL/min/1.73m2 for azotemia, ALT level <35 in men and <25 IU/mL in women as normalization were accepted. Results: 225 patients were included in this study [age 57 years (IQR 48-65) , male 158 (70.2%), follow-up period 22 months (IQR 12-30), cirrhotic 43 (19.1%), decompensated 25/43 (58.1%), 72 post-liver transplant, 41 prophylaxis against reactivation]. 39 patients were treatment naive, 186 patients were switched to TAF from various anti-virals [TDF 164 (88%), ETV 18 (10%), others 4 (2%)]. Hypophosphatemia, azotemia and ostoporosis were the most common causes (67%) of switching to TAF. The viral load of anti- viral naive patients was sup-pressed significantly (p=0.011) and virologic response improved significantly in switch to TAF group (p=0.003) (fig1). HBsAg loss did not occur in any patient. eGFR levels before and after TAF treatment did not change significantly in total group unlike low baseline eGFR level group, eGFR levels increased significantly 6-12 months after TAF (p<0.001). After 6-12 months of TAF therapy, phosphorus levels improved significantly in both the total group and the low phosphorus group (p<0.001, fig1). Renal toxicity did not occur in naive group. LDL and triglyceride levels did not change sig-nificantly in the total group after TAF treatment. 33 pa-tients had abnormal ALT levels in switch to TAF group, 29 of them have normalized after treatment. There was no need to give up treatment due to adverse reactions. Conclusion: TAF has a potent viral suppressive effect in treatment-naive and experienced patients with CHB. Patients switched to TAF have improved renal function (characterized by elevated eGFR and Pi levels). TAF provided ALT normalization of patients and did not af-fect their lipid profiles. In CHB patients, TAF was safe, well-tolerated and effective in this real-world cohort

Is Having Inflammatory Bowel Disease a Risk Factor for Severe Acute Respiratory Syndrome Coronavirus 2?

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 virus was found to have effects not only in the lungs but also in many different organs. We aimed to evaluate the management of our patients with inflammatory bowel disease in this pandemic, the incidence of coronavirus disease 2019 in terms of clinical, medical treatment, and features of inflammatory bowel disease, and to investigate the effects of the severe acute respiratory syndrome coronavirus 2 on this particular group of patients. METHODS: During the coronavirus disease 2019 pandemic, 207 patients who had inflammatory bowel disease for at least 6 months were questioned for coronavirus disease 2019 at their outpatient clinic admissions, and their medical records were evaluated prospectively. RESULTS: Of the 207 patients, 146 had Crohn's disease. The mean disease duration was determined as 118.15 ± 72.85 months. Of the patients, 127 (61.4%) were using mesalazine, 110 (53.1%) azathioprine, and 148 (71.5%) biological agents. It was found that 66 (31.9%) patients changed their medications during the coronavirus disease 2019 pandemic. As a medication change, anti-Tumor Necrosis Factor (TNF) dose was observed to be omitted most frequently at a rate of 80%. Diarrhea was present in 20.8%, abdominal pain in 20.3%, nausea in 10.6%, anorexia in 13.5%, and weight loss in 15.9% of the patients. Twelve (5.79%) patients were diagnosed with coronavirus disease 2019. Lung involvement was present in 11 (91.7%) of the patients diagnosed with coronavirus disease 2019. Of the patients diagnosed and not diagnosed with coronavirus disease 2019, 75% vs. 71.6% were using biological agents (P = .80), respectively. Half of the patients diagnosed with coronavirus disease 2019 were active in terms of inflammatory bowel disease at the time of diagnosis, and 2 of these patients were severely active. CONCLUSION: The incidence of coronavirus disease 2019 infection in patients with inflammatory bowel disease was not different from the general population during the severe acute respiratory syndrome coronavirus 2 pandemic. Coronavirus disease 2019 infection does not progress with poor prognosis in patients with inflammatory bowel disease who receive immunosuppressive therapy including biological agents